Clinical case report: Sclerosing hemangioma of the liver, a rare but great mimicker

Behbahani, Siavash; Hoffmann, Jason C.; Stonebridge, Renee; Mahboob, Sabrina

doi:10.1016/j.radcr.2016.02.015

Cited by 10 publications

(13 citation statements)

References 5 publications

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“…In contrast however, they could also show geographic pattern, capsular retraction, and loss of previously seen regions of enhancement [ 9 ]. The radiological features of sclerosing hemangiomas revealed by dynamic CT and MRI are similar to those of hepatic malignancies making the diagnosis highly challenging based on imaging alone [ 10 ]. It is hypothesized, however, that the use of [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) could be helpful in the preoperative diagnosis to distinguish benign sclerosed hemangioma from a malignant tumor such as intrahepatic cholangiocarcinoma or metastatic liver cancers [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Hepatic Sclerosing Hemangioma Mimicking Malignancy: A Case and Literature Review

Liu¹,

Klar²,

Alawad³

et al. 2020

AJMCR

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Background: Sclerosing hemangiomas of the liver are rare, benign tumors with degenerative changes. These degenerative changes, however, often obscure the true, benign nature of the tumor and give them features indistinguishable from other malignant processes, thus making the diagnosis difficult. Case presentation: A 70-year-old male without any previously diagnosed liver disease or malignant process presented with incidental right hepatic mass in ultrasonography and weight loss. Physical exam was unremarkable. The labs were significant for mild pancytopenia, elevated total bilirubin and slightly decreased transferrin. Follow-up triple phase-contrast CT scan of the abdomen revealed a lobulated, poorly demarcated lesion measuring 4.8 x 4.5 cm, located in segment V of the liver with encasement of the left portal branch. The overall picture was indeterminate but highly suspicious for malignancy. A decision was made to perform a CT-guided biopsy which revealed sclerosing hemangioma of the liver. Conclusion: It is challenging to differentiate sclerosing hepatic hemangioma from atypical hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and metastatic tumors utilizing only imaging modalities. The diagnostic workup should include biopsy of the atypical liver lesion which unveils the final diagnosis and avoid subjecting the patient to an extensive, and invasive surgical resection.

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Section: Discussionmentioning

confidence: 99%

Hepatic Sclerosing Hemangioma Mimicking Malignancy: A Case and Literature Review

Liu¹,

Klar²,

Alawad³

et al. 2020

AJMCR

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“…Hepatic sclerosing hemangiomas are caused by degenerative changes such as thrombus formation, necrosis, and scar formation within liver cavernous hemangioma, and such variations in the pathological characteristics make precise radiological diagnosis very difficult 5. Sclerosing hemangioma is frequently misdiagnosed as an intrahepatic malignancy or metastatic lesions, for which a hepatectomy is performed 5–8. In the present case, the preoperative contrast MRI captured a large hepatic cavernous hemangioma and the sclerosing hemangioma could not be detected, because most of the tumor was composed of cavernous hemangiomas.…”

Section: Discussionmentioning

confidence: 99%

<p>Resection as first-line therapy for large hepatic sclerosing hemangioma: a case report</p>

Yang

Shi

et al. 2019

OTT

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Hepatic sclerosing hemangioma is a rare benign disease that occurs in association with hepatic cavernous hemangioma degeneration and sclerosis. Recent studies have shown that radiofrequency (RF) ablation is an alternative treatment for hepatic cavernous hemangiomas, even for large hemangiomas (≥10 cm). However, RF ablation might not be suitable to treat large sclerosing hemangiomas. We herein report the successful surgical removal of a large hepatic sclerosing hemangioma after RF ablation treatment failure in a 65-year-old man. In conclusion, we suggest that resection should be chosen as a first-line therapy for the disease.

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“…Most of the tumors reported previously were resected due to preoperative misdiagnosis as hepatic malignancies. Behbahani et al have shown that knowledge of the appearance of atypical hemangioma and its inclusion in the differential diagnosis of hepatic lesions can alter patient management, being an important aspect to consider before invasive therapies are planned [ 9 ]. On the other hand, in fine-needle aspirates, the smears tend to be hemorrhagic, and sometimes only blood is aspirated.…”

Section: Discussionmentioning

confidence: 99%

Hepatic Sclerosing Hemangioma with Predominance of the Sclerosed Area Mimicking a Biliary Cystadenocarcinoma

Sugo

Sekine

Miyano

et al. 2018

Case Reports in Hepatology

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We report here an extremely rare case of hepatic sclerosing hemangioma mimicking a biliary cystadenocarcinoma. A previously healthy 39-year-old woman was referred to our hospital because of a large tumor in the liver. Abdominal computed tomography revealed early peripheral ring enhancement in the arterial phase and slight internal heterogeneous enhancement in the delayed phase. Magnetic resonance imaging revealed a tumor with low intensity in the T1-weighted image and very high intensity in the fat-saturated T2-weighted image. The patient underwent hepatectomy for a possible malignant liver tumor. Grossly, the tumor appeared as a white, solid, and cystic mass (weighted 1.1 kg and measured 170×100×80 mm) that was elastic, soft, and homogeneous with a yellowish area. Histological examination showed that the tumor mostly consisted of fibrotic areas with hyalinization. The typical histology of cavernous hemangioma was confirmed in part, and the tumor was diagnosed as a sclerosing hemangioma with predominancy of the sclerosed area. A review of 20 cases reported previously revealed that only 2 (10%) patients were diagnosed as having sclerosing hemangioma preoperatively.

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Clinical case report: Sclerosing hemangioma of the liver, a rare but great mimicker

Cited by 10 publications

References 5 publications

Hepatic Sclerosing Hemangioma Mimicking Malignancy: A Case and Literature Review

Hepatic Sclerosing Hemangioma Mimicking Malignancy: A Case and Literature Review

<p>Resection as first-line therapy for large hepatic sclerosing hemangioma: a case report</p>

Hepatic Sclerosing Hemangioma with Predominance of the Sclerosed Area Mimicking a Biliary Cystadenocarcinoma

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