Recently, Mr. Wang found that hemangiomas had grown on his liver during a physical examination in the hospital, and he was very anxious after returning home, afraid that he had an incurable disease. Looking up on the Internet, some people say that hemangiomas of the liver will grow larger, become cancerous, and must be treated surgically. Mr. Wang was not lightly frightened, so he came to the Second People's Hospital of Hunan Province (Hunan Provincial Brain Hospital) for further examination.
Jiang Bing, deputy chief physician of the Department of Radiology, looked at the film he did with an epigastric CT scan and enhancement, which was a typical manifestation of hemangioma from the image, and asked Mr. Wang whether he had a history of hepatitis, and Mr. Wang said that he did not. Dr. Jiang explained that hemangiomas are benign tumors that are very common in the liver, and the pathological type of cavernous hemangioma is the most common. Or more precisely, hepatic hemangiomas are made up of abnormally dilated blood sinuses, not tumors in the true sense.
Hemangiomas have been reported to grow slowly, but rupture of hemangiomas is extremely rare and there is currently no evidence to support malignancy. Smaller hemangiomas of the liver are generally asymptomatic and are mostly detected during a physical examination. Symptoms such as vague abdominal pain or compression of surrounding organs occur only when the hemangioma is large enough or in a special location.
Hepatic hemangiomas are often distinguished from liver cancer, so what can be done to distinguish between liver hemangiomas and liver cancer?
Liver cancer is a common malignancy of the liver, the cause of which is not yet known, and is currently thought to be associated with cirrhosis, viral hepatitis B and C, and consumption of aflatoxin-contaminated foods. It generally has symptoms such as pain, fatigue, lack of energy, loss of appetite and weight loss in the liver area of the epigastric region, and is often accompanied by an increase in serum alpha-fetoprotein.
Hemangiomas, on the other hand, are mostly thought to be associated with congenital dysplasia. Hepatic hemangiomas are generally asymptomatic, the liver is soft, there is no background of liver disease, and there are no clinical symptoms when the tumor is small. However, a small number of tumors gradually increase in volume, compressing the surrounding organs and causing clinical symptoms. The physical examination found that there are mass lesions on the liver, and if you are worried about malignancy, you can recommend going to the hospital for further examination. CT-enhanced scan can better distinguish between liver cancer and hepatic hemangioma, and can also draw blood to test for alpha-fetoprotein.
Does hemangioma of the liver need treatment?
It has been reported in the literature that the more stringent indications for surgery are:
1. Hepatic hemangiomas with clear symptoms, especially when the diameter of the tumor body > 10 cm;
2. Malignant tumors cannot be excluded, especially those with hepatitis B or elevated AFP;
3. Rupture of tumor body or accompanied by large-flow arteriovenous fistula and coagulation dysfunction.
In addition to surgical resection, there are many minimally invasive treatment methods including hepatic artery intervention embolism and radiofrequency ablation. Therefore, for Mr. Wang's situation, there is no need to be overly nervous, and regular physical examination and review can be done.
Contributed by: Jiang Xili, Department of Radiology, Second People's Hospital of Hunan Province (Hunan Brain Hospital).
Editor: Liu Yuchen
Photo: Jiang Xili