Transcatheter arterial embolization in the treatment of symptomatic cavernous hemangiomas of the liver: a prospective study

Srivastava, Deep Narayan; Gandhi, Dheeraj; Seith, Ashu; Pande, Girish; Sahni, P.

doi:10.1007/s00261-001-0007-x

Cited by 111 publications

(103 citation statements)

References 8 publications

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“…These results were compatible with study by Firouznia et al [18]. Risks associated with TAE include pain, inoperability, non-target embolization, bile duct injury, pyrexia, leukocytosis, and nausea [15,19,34,35]. When performed before surgical resection, TAE can improve hepatic mobility and reduce intraoperative blood loss [19,20,23].…”

Section: Discussionsupporting

confidence: 88%

“…For this reason, surgical resection remains an attractive option if the hemangioma is deeply located in the liver parenchyma, occupies an entire lobe, or does not have a free surface from Glisson's capsule [13]. Trans-arterial embolization has been proposed as a treatment option in giant symptomatic hemangiomas, both alone and in combination with resection [15][16][17][18][19][20][21][22]. In a study of 98 patients with a hemangioma > 5cm, TAE monotherapy resulted in resolution of pain and distension in 87% of patients with baseline symptoms, with partial reduction in the other 13% [22].…”

Section: Discussionmentioning

confidence: 99%

“…Although traditionally treated with surgical resection or enucleation alone, recent treatment modalities include trans-arterial embolization (TAE), radiotherapy, radiofrequency ablation, transplant, chemotherapy, or multi-modal therapy [13]. Trans-arterial embolization has been proposed as a treatment option in giant symptomatic hemangiomas, both alone and in combination with resection [15][16][17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

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Preoperative Trans-Arterial Embolization and Surgical Resection for Giant Liver Hemangioma: A Multidisciplinary Approach

Tieniber¹,

Shah²,

Eng³

et al. 2017

JGPLD

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A 47-year-old male presenting with abdominal distension and pain was found to have a giant hemangioma of the liver measuring 22cm in its greatest diameter upon preoperative MRI. The patient underwent preoperative trans-arterial embolization (TAE) of the hemangioma, followed by extended right hepatectomy for definitive treatment. This case illustrates a novel multidisciplinary approach to the treatment of a massive liver hemangioma. We propose a new classification of these > 20 cm hemangiomas that require preoperative TAE as "Super Hemangiomas."

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Preoperative Trans-Arterial Embolization and Surgical Resection for Giant Liver Hemangioma: A Multidisciplinary Approach

Tieniber¹,

Shah²,

Eng³

et al. 2017

JGPLD

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“…A possible reduction of symptoms has been noted after TAE, however, there was no change in tumour size and recurrence was common [22]. In complicated hemangioma, transarterial embolization is used before surgery to stabilize ruptured lesion.…”

Section: Non-surgical Therapiesmentioning

confidence: 99%

Therapeutic Options of Giant Liver Hemangioma

Boukerrouche

2018

JLRDT

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Liver hemangiomas are commonly the most frequent benign lesion of the liver. They are generally smaller, asymptomatic and diagnosed incidentally in imaging studies. A liverhemangioma is qualified giant when it has a size larger than 5cm. Asymptomatic and non-complicated giant liver are managed conservatively by observation. However, lesion with incapacitating symptoms or complications is managed surgically. Surgery remains the most effective and radical therapeutic modality to treat liver hemangioma. Thus both enucleation and liver resection can be performed to remove the lesion. However recent studies demonstrated that enucleation was a safer, Quaker surgical procedure and associated with lower complication and less blood loss. Non-surgical treatment options have been described to be used alone or in combination with surgery. This mini-review provides a general view of the therapeutic options employed to treat giant liver hemangioma.

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“…Among the other therapeutic options described in the literature, one option is arterial embolization, where the branches of the hepatic artery are embolized with polyvinyl alcohol and other substances that would cause a decrease in tumor size and relief of symptoms [16]. However, rapid development of hepatic arterial collaterals decrease the final benefit of this non-extensive procedure.…”

Section: Treatmentmentioning

confidence: 99%

Review Article: A Giant Hepatic Hemangiomas

Montero¹,

Guerra-Canchari²,

Peña³

et al. 2017

GHOA

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with this condition (HH that measure more than 10cm) are more susceptible to present symptoms and complications [2]. EpidemiologyIt is the second most common tumor in the liver after metastasis and represents 73% of all benign liver tumors, although its frequency in autopsy studies is less than 0.4% [2,3], some studies indicate that its prevalence and incidence can reach 20% and 7% of the general population, respectively [3,4].Generally, these tumors affect adult women in their third and fifth decade of life, mainly multiparous women. However, it is important to mention that it can occur at any age of life [3,5]. The female to male ratio ranging from 3: 1 to 5: 1 according to preview studies [2][3][4][5]. EtiopathogenesisThe etiopathogenesis of HH is not yet fully understood, however, it has been postulated that they are vascular malformations or hamartomas of congenital origin that are produced secondary to an intense ectasia due to hypertrophy or vascular hyperplasia [5]. There are different theories about the genetic component: Moser C et al. [6] reported the case of an Italian family, where three female members in three successive generations had symptoms related with HH and two other relatives showed asymptomatic HH on ultrasound. Likewise, Diez Redondo P et al. [7] reported a family in which six members from three successive generations presented HH, suggesting that a clear family component might exist.Women's disease preference may be explain by the expressiveness of a presumed "HH gene", proliferate factors are the condition of been a woman, increased production of female sex hormones (during puberty or pregnancy) or the use of oral contraceptives. In fact, there are reports of growth and rupture of these tumors during pregnancy or in menopausal women undergoing hormonal treatment [2,5]. Clinical FeaturesIn most cases HH do not present symptoms, they are most likely to be discovered incidentally during imaging studies for other unrelated conditions and if they present symptoms, they are nonspecific common symptoms to many other diseases of digestive origin (nausea, pain, abdominal distention, early satiety) [4]. Some authors report that there is a close relationship between tumor size and the presence of symptoms, 40% of the patients present symptoms in cases that hemangiomas measure more than 4 cm and 90% in cases that hemangiomas measure more than 10 cm denominated giant hepatic hemangiomas (HHG). Mainly symptoms are upper abdominal pain usually mild, but that can become severe in cases of thrombosis or bleeding within the lesion, which stretches and inflames Glisson's capsule [5].Physical examination is usually normal without significant findings, only rarely the hemangioma is presented as a large abdominal mass and an arterial murmur in the upper quadrant (Figure 1). Complications will depend on the location of the tumor and is generally present in cases of giant hemangiomas (HHG). It has been described circulatory shock and hemoperitoneum with Review ArticleGastroenterol Hepatol Open Access 2017, 7...

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Transcatheter arterial embolization in the treatment of symptomatic cavernous hemangiomas of the liver: a prospective study

Abstract: TAE of hepatic cavernous hemangioma is a useful procedure in the therapy of symptomatic hemangiomas.

Cited by 111 publications

References 8 publications

Preoperative Trans-Arterial Embolization and Surgical Resection for Giant Liver Hemangioma: A Multidisciplinary Approach

Preoperative Trans-Arterial Embolization and Surgical Resection for Giant Liver Hemangioma: A Multidisciplinary Approach

Therapeutic Options of Giant Liver Hemangioma

Review Article: A Giant Hepatic Hemangiomas

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