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Hepatic hemangioma
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Hepatic hemangioma

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Contributors: Abhijeet Waghray MD, Nishant H. Patel MD, Desiree Rivera-Nieves MD, Khaled Bittar MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Hepatic hemangiomas, also known as cavernous hemangiomas, are common benign mesenchymal tumors of the liver. The majority of hepatic hemangiomas are solitary and can range in size from a few millimeters to over 20 cm (giant hemangiomas). Prevalence of hepatic hemangiomas range from 0.4%-20%, with diagnosis most frequently between the third and fifth decade of life.

Most hepatic hemangiomas are asymptomatic and are incidental findings on abdominal imaging. Larger lesions are more likely to cause symptoms, including abdominal pain (especially in the upper right quadrant), nausea, and anorexia. Women are 3 times as likely to develop hemangiomas and are more likely to experience symptoms. The etiology of hepatic hemangiomas is unclear, but hormonal influence over tumor enlargement may explain the higher incidence of symptomatic lesions in women. Lesions may grow during pregnancy and in the setting of oral contraceptive therapy. Surgical resection may be necessary for patients experiencing pain.

Codes

ICD10CM:
D18.09 – Hemangioma of other sites

SNOMEDCT:
93469006 – Hemangioma of liver

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Hepatic cysts
  • Hepatic adenoma
  • Regenerating nodules
  • Hepatic abscess
  • Focal nodular hyperplasia
  • Liver angiosarcoma
  • Hepatocellular carcinoma
  • Benign hepatic tumor, including mesenchymal hamartoma due to DICER1 deficiency

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 01/08/2018
Last Updated: 05/22/2019
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Hepatic hemangioma
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Hepatic hemangioma : Hepatic mass, RUQ pain
Imaging Studies image of Hepatic hemangioma
Contrast enhanced axial CT scan of the abdomen demonstrates a mass in the right lobe of the liver with peripheral enhancement, consistent with hepatic hemangioma.
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