Hepatic hemangioma: A case of spontaneous involution

Hepatic hemangiomas are benign, well-circumscribed tumors often found incidentally on imaging. They are estimated to be prevalent in 0.4-20% of the population. While usually solitary lesions, these tumors tend to not cause any issues for patients. However, when they grow to be larger than 5 cm, there can be associated symptoms including pain, nausea, or early satiety from compression on adjacent structures. There can be more rare, serious complications including hemobilia, rupture, coagulopathy, or high output heart failure seen in tumors that are typically larger than 10 cm. While small hepatic hemangiomas (<5 cm) that do not cause symptoms do not need to be followed, ones that are greater than 5 cm should be followed at least once to ensure that they are stable in size, or more regularly if they are growing. Symptomatic large hepatic hemangiomas can be intervened on with a number of procedures if needed. These include hepatectomy, enucleation, transcatheter arterial embolization, radiofrequency ablation, and in rare cases, liver transplant.