Hemangiomas are bundles of blood vessels that can form into benign, or noncancerous, tumors in the liver. It is estimated that between 1% and 5% of people in the U.S. have a liver hemangioma that does not cause symptoms. Many people who have a liver hemangioma do not even know they have one.
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What Is Liver Hemangioma?
A liver or hepatic hemangioma is a tumor that is created through a cluster of blood vessels in the liver. Most commonly, these tumors are benign and are often found accidentally in routine x-ray screenings.
Hemangiomas may be confined to one lobe of the liver or spread throughout the entire liver. Based on the size of the tumor growth, hemangiomas are classified as either small or giant for growths over 5 cm.
What are the types of liver hemangiomas?
Liver hemangiomas are separated into two categories:
- Capillary — A mass made up of many small blood vessels, held together by a thin layer of tissue.
- Cavernous — A mass made of wide or dilated blood vessels where blood fills the spaces between the vessels. This is the most common form of hemangioma.
How common is liver hemangioma?
Hemangiomas are more commonly found in women than in men and typically occur in people between the ages of 30 and 50. These masses can form at any point in a person’s life; in fact, some babies are even born with hemangiomas. Infants may have hemangiomas known as benign infantile hemangioendothelioma.
What causes liver hemangioma?
The direct cause of hemangiomas is still unknown. Some researchers believe that too much vascular endothelial growth factor (VEGF) may lead to the growth of hemangiomas. VEGF is produced by the body’s cells to tell your body to build blood vessels.
Liver hemangiomas are formed as a result of vascular malformation with a growing pattern of dilation — the enlargement or widening of vessels allowing for an increased flow of blood. They are not the result of hypertrophy (enlargement of an organ by the growth of its cells) or hyperplasia (enlargement of an organ as a result of an increase in the reproduction rate of its cells).
Liver hemangioma risk factors
Hemangiomas that grow larger than 4 cm might cause:
- Abdominal pain in the upper right quadrant.
- Blood clots.
- Heart failure.
- Pressure on the organs around the liver.
Complications of liver hemangioma
Although liver hemangiomas are largely benign and asymptomatic, larger hemangiomas can result in complications in the abdominal region of the body and the organs near the liver.
Left undiagnosed or untreated, a hemangioma can continue to grow and cause complications in the body and surrounding organs, particularly.
How can I prevent liver hemangioma?
While these growths cannot be fully prevented, and do not require lifestyle changes, your doctor might suggest taking steps to ensure your liver is healthy, like:
- Eating a healthy, balanced diet.
- Exercising regularly
- Limiting alcohol intake
What Are the Signs and Symptoms of Liver Hemangioma?
Most liver hemangiomas are benign and too small to present symptoms.
However, based on the size and placement of these liver growths, their symptoms may include:
- Bloating after a meal.
- Feeling full prematurely.
- Nausea.
- Pain or discomfort in the stomach.
A baby born with hemangioendothelioma is at risk for complications such as:
- Anemia.
- A bloated belly.
- Death.
When should I see a doctor about my liver hemangioma symptoms?
Most liver hemangiomas are found in a routine radiological scan. However, if you are experiencing symptoms of pain in the upper right quadrant of the abdomen or can feel a palpable growth on your side, you should see your doctor immediately.
How Do You Diagnose Liver Hemangioma?
Liver hemangiomas are commonly found during imaging tests for other health conditions.
Tests to diagnose liver hemangioma
These imaging tests include:
- CT scan – Very well suited to spotting and identifying liver hemangiomas.
- MRI – The most effective in identifying liver hemangiomas.
- Ultrasound – Uses sound or other vibrations with ultrasonic frequencies to create an image. It is harder to identify a liver hemangioma using an ultrasound, but it might be the first test to identify an abnormality in the liver.
Your doctor might order any of these tests if they suspect you have a liver hemangioma. Typically, there is no need for a liver biopsy to test a sample of the liver tissue, as these growths are rarely malignant.
Liver hemangioma prognosis
Liver hemangiomas are most commonly benign growths that can be either ignored, if they are small, or easily removed. Therefore, the survival rate is very high, and they cause only minor lifestyle changes.
How Do You Treat Liver Hemangioma?
The treatment plan for a liver hemangioma is based on the size and location of the mass. If the hemangioma has grown larger than 4 cm, it could complicate the function of the other organs in the surrounding region of the liver.
Small hemangiomas can be left untreated unless they pose the potential to continue growing.
For larger hemangiomas, treatments include:
Medicine to treat liver hemangioma
Transarterial embolization is a treatment in which doctors inject medicine into the hepatic artery to block the blood flow to the liver. This injection helps reduce the tumor’s size and stops it from growing larger. Another option is hepatic ligation, in which doctors tie off the liver’s artery to prevent blood from reaching the mass. Corticosteroids are commonly prescribed as well to reduce the swelling.
Surgery for liver hemangioma
If the mass is large enough to warrant removal, your doctor might opt for surgery. If your surgeons can easily remove the hemangioma on its own, they will, but in some cases, the growth is so intertwined with the liver that a portion of the liver may need to be removed as well.
When the hemangioma and the liver are intertwined, your surgeon might offer the option of a liver transplant.
This option may be considered if:
- The mass cannot be separated from healthy liver tissue and it's putting pressure on other organs or causing pain.
- The hemangioma is at risk of rupturing.
- There are many masses throughout the liver, affecting the organ’s function.
How effective is treatment?
Treatment for liver hemangioma is usually very effective but may require follow-up appointments to monitor healing and tumor regrowth.
