Uncommon evolutions and complications of common benign liver lesions

Vernuccio, Federica; Ronot, Maxime; Burgio, Marco Dioguardi; Lebigot, J.; Allaham, Wassim; Aubé, Christophe; Brancatelli, Giuseppe; Vilgrain, Valérie

doi:10.1007/s00261-017-1427-6

Cited by 13 publications

(13 citation statements)

References 96 publications

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“…Spontaneous hemorrhage and Kasabach-Merritt syndrome are rare [22,23]. In the current study, there was no spontaneous or traumatic intraperitoneal hemorrhage occurred, no recorded Kasabach-Merritt syndrome as it is recorded in children and our cases were adult.…”

supporting

confidence: 41%

Natural history of hepatic hemangiomas as a guide for surgical indication

Mogahed¹,

Zytoon

Essa³

et al. 2020

Egypt Liver Journal

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Background Generally, hemangiomas are asymptomatic and most lesions are incidentally diagnosed on abdominal ultrasonography. The indications for surgery are still debated mainly due to limited data about the natural history of hepatic hemangiomas. The aim of this study is to investigate the natural history of hepatic hemangiomas, the effects of age and sex on their growth, and their tendency to increase in size or causing symptoms or complications as a guide for surgical indication. In this current study, combined retrospective and prospective analysis was conducted on 186 Egyptian adult patients having 244 hepatic hemangiomas who attended to the outpatient clinics. Follow-up was performed to observe the accurate site, size, number, rate of growth of the lesions, and their tendency to cause symptoms or complications. Results Ninety-one percent of patients were asymptomatic and 9% were symptomatic. During follow-up, 48% of patients showed an increase in tumor diameter, 22% decreased, and 30% were stable. The growth rate at 18–45-year group showed an increasing trend that was higher in females; it was 3.3 ± 2 mm/year for males and 3.9 ± 1.8 mm/year for females. At ˃ 45 year group, the female patients showed a decreasing trend (− 2.1 ± 1.1 mm/year) while in males showed an increasing trend that was slower than in 18–45-year group (2.6 ± 1.7 mm/year). Conclusion Growth pattern of liver hemangiomas is affected by age and sex. The majority of hemangiomas are asymptomatic and complications are rare. Hemangioma size alone is not an indication for surgery in asymptomatic patients. Surgical indications are limited to patients with severe symptoms, complications, or suspicious lesions. Most hemangiomas can be managed conservatively even giant hemangiomas.

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supporting

confidence: 41%

Natural history of hepatic hemangiomas as a guide for surgical indication

Mogahed¹,

Zytoon

Essa³

et al. 2020

Egypt Liver Journal

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“…Hepatic hemangiomas are often found incidentally on abdominal ultrasonography (Adriana et al, 2014), and atypical lesions should be further investigated with contrast-enhanced imaging studies such as CT scan and MRI (Satoshi et al, 2009). Abdominal pain and discomfort caused by dilatation of the liver capsule are the most common clinical manifestations of symptomatic hepatic hemangioma, whereas spontaneous hemorrhage and Kasabach-Merritt syndrome are rare, but extremely dangerous (Trotter and Everson 2001;Vernuccio et al, 2018; Kamyab and Rezaei-Kalantari 2019), and the mortality rate of Kasabach-Merritt syndrome has been reported to be up to 40% (O'Rafferty et al 2015). In our study, the majority of patients with hepatic hemangioma are asymptomatic, and most of the lesions were found due to physical examination, other gastrointestinal diseases and abdominal discomfort.…”

Section: Discussionmentioning

confidence: 99%

“…Related studies have found that estrogen receptors are expressed in hepatic hemangioma and that high estrogen conditions (such as pregnancy and use of oral contraceptives) can promote their growth (Gemer et al 2004;Au and Liu 2005;El-Hashemite et al 2005;Yeh et al 2007b;van Malenstein et al, 2011). Although there have been reports on the natural growth history of hepatic hemangioma, no consensus has been reached (Glinkova et al 2004;Yeh et al 2007a;Hasan et al 2014;Vernuccio et al, 2018). This study investigated the epidemiological characteristics of and the factors affecting the growth of hemangioma, such as age and sex, by analyzing the case data of 534 patients, and hope that our results can provide a theoretical basis for the development of personalized treatment and follow-up programs.…”

Section: Introductionmentioning

confidence: 92%

Natural history of hepatic hemangioma: a follow-up analysis of 534 patients

Wang

Deng

Qian

et al. 2019

Frontiers in Life Science

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Background: The effects of gender and age on the growth of hepatic hemangioma remain inconclusive. This study aims to further explore the natural growth of hepatic hemangioma and its influencing factors. Methods: From June 2014 to April 2019, 534 untreated patients who were diagnosed with hepatic hemangioma in our hospital were enrolled. The growth changes of hepatic hemangioma were observed at follow-up by ultrasound. Results: During the median 18 (14,22) (months of follow-up, 215 (40.3%) patients showed an increase in tumor diameter, 217 (40.6%) tumor diameters decreased, and102 (19.1%) tumor diameters did not change. Before the age of 40, the diameter of hemangiomas in each group of men and women increased with age. After 40 years old, those in men continued to grow slowly, while those in women had a relatively downward trend. Therefore, by investigating annual changes in tumor, it was found that the diameter of female tumors showed a significant downward trend after the age of 40, the difference is most pronounced between 50-60 years old (the annual change is −0.39 (−0.87,0.40) cm). Conclusion: In the natural growth process of hepatic hemangioma, male and female patients present different trends, which may be related to sex.

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“…FNH is defined as a nodule composed of benign-appearing hepatocytes occurring in a liver that is otherwise histologically normal or nearly normal [26]. Although FNH may increase in size in 3-15% of cases, these lesions do not evolve to malignancy and their management is conservative [27,28]. FNHs show iso-or hyperintensity in the HBP relatively to liver parenchyma in the vast majority (97%) of cases [10] (Fig.…”

Section: Non-cirrhotic Patientsmentioning

confidence: 99%

Spectrum of liver lesions hyperintense on hepatobiliary phase: an approach by clinical setting

et al. 2021

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Hepatobiliary MRI contrast agents are increasingly being used for liver imaging. In clinical practice, most focal liver lesions do not uptake hepatobiliary contrast agents. Less commonly, hepatic lesions may show variable signal characteristics on hepatobiliary phase. This pictorial essay reviews a broad spectrum of benign and malignant focal hepatic observations that may show hyperintensity on hepatobiliary phase in various clinical settings. In non-cirrhotic patients, focal hepatic observations that show hyperintensity in the hepatobiliary phase are usually benign and typically include focal nodular hyperplasia. In patients with primary or secondary vascular disorders, focal nodular hyperplasia-like lesions arise as a local hyperplastic response to vascular alterations and tend to be iso- or hyperintense in the hepatobiliary phase. In oncologic patients, metastases and cholangiocarcinoma are hypointense lesions in the hepatobiliary phase; however, occasionally they may show a diffuse, central and inhomogeneous hepatobiliary paradoxical uptake with peripheral rim hypointensity. Post-chemotherapy focal nodular hyperplasia-like lesions may be tricky, and their typical hyperintense rim in the hepatobiliary phase is very helpful for the differential diagnosis with metastases. In cirrhotic patients, hepatocellular carcinoma may occasionally appear hyperintense on hepatobiliary phase.

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Uncommon evolutions and complications of common benign liver lesions

Cited by 13 publications

References 96 publications

Natural history of hepatic hemangiomas as a guide for surgical indication

Natural history of hepatic hemangiomas as a guide for surgical indication

Natural history of hepatic hemangioma: a follow-up analysis of 534 patients

Spectrum of liver lesions hyperintense on hepatobiliary phase: an approach by clinical setting

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