A hepatic hemangioma is an unusual, slow-growing mass of blood vessels in the liver. It is a benign condition that rarely causes any symptoms or adverse health effects. Most people who have hepatic hemangiomas are either never diagnosed or unaware of the fact until they undergo diagnostic imaging scans for other problems. Treatment is usually unnecessary, though people who experience internal bleeding, frequent cramps, or liver inflammation may be scheduled for surgery.
The causes of hepatic hemangioma are not known. Research suggests that certain hormones, including estrogen and progesterone, may play a role in their development. Women are as much as six times more likely to develop hemangiomas than men, and masses are more likely to grow if a person takes steroids, birth control pills, or estrogen hormone replacement drugs. Initial tumors are usually present from birth and never grow more than about half an inch (about 1.25 centimeters) in diameter. They are made up of clusters of oddly-shaped blood vessels.
The majority of hepatic hemangiomas do not cause symptoms, especially if they are very small. A large tumor may irritate the lining of the liver or rupture and bleed if the abdomen suffers physical trauma. When symptoms appear, they usually include pain and tenderness in the upper abdomen. A person may lose his or her appetite or feel full after consuming small portions of food. Frequent bouts of nausea and vomiting are uncommon but possible when the liver is damaged by a hepatic hemangioma.
When a doctor notices a small mass in the liver on diagnostic tests, he or she usually arranges for further exams to determine if it is a benign hepatic hemangioma or a cancerous tumor. Computerized tomography scans, ultrasounds, and magnetic resonance imaging can all be helpful in revealing the nature of the mass. If tests are inconclusive, a liver biopsy may be scheduled to confirm the diagnosis.
Treatment is not recommended for most patients who have hemangiomas that do not cause symptoms. If a hepatic hemangioma is very large or has already ruptured, however, surgery may be needed to prevent possible complications. There are a few different options for surgery, including excision of the tumor itself, removal of a portion of the liver containing the mass, or ligation of the blood vessels that feed the hemangioma. Very rarely, a patient may require a liver transplant if the organ's functioning is severely compromised. Hemangiomas are unlikely to return following successful surgeries.