Imaging Characteristics and Management of Infected Hepatic Hemangioma: Case-in Discussion

Abstract

Hepatic hemangiomas are the most common type of benign liver tumors. We present a case of an infected hepatic hemangioma, which posed a diagnostic challenge. A 43-year-old female presented with right upper quadrant pain after blunt force trauma and intentional weight loss. CT and MRI were done, showing a posterior right lobe liver mass. Imaging characteristics were thought to be suggestive of metastatic disease, with a differential diagnosis of abscess. Drainage and biopsy of the mass revealed Streptococcus sp. infection, and pathology showed a cavernous hemangioma with inflammation. Patients presenting with systemic symptoms and an indeterminate liver mass on imaging should be evaluated for infected hepatic hemangiomas. Biopsy may be needed to rule out cancer. Management may include surgical resection; however, antibiotics and percutaneous drainage can suffice, as in this case.

Hepatic Hemangioma: Review of Imaging and Therapeutic Strategies

“…However, advancements and increased accessibility of various imaging methods have shifted this paradigm. Some researchers now view MRI as the gold standard for diagnosing hepatic hemangiomas [ 105 , 106 ], while others advocate for IV contrast-enhanced abdominal CT scans [ 69 , 107 ]. Furthermore, the role of biopsy and histopathological examination in evaluating liver lesions, especially atypical ones that may resemble malignancies, is crucial, despite the associated risks of such invasive procedures [ 108 , 109 ].…”