Introduction:
Hemangioma is a bright red birthmark that may show up in the first or second week of life. They may look like bumps (rubbery bumps) which are made up of blood vessels in the skin. Their occurrence can be in any part of the body, but they mainly appear on the scalp, chest, face, and back. This occurs due to extra blood vessels that group together in a dense cluster, but the cause of this is unknown. This occurs most often in female babies.
What Is Hepatic Hemangioma?
The most common benign tumor which affects the liver is hemangioma. They are mesenchymal (cells that develop into connective tissue, lymphatic tissue, and blood vessels) in origin. These hemangiomas are composed of masses of blood vessels that are atypical or irregular in arrangement and size. Usually, an individual with hemangioma has only one bump, but in some rare cases, there may be multiple hemangiomas. They do not turn into cancer or spread to other parts of the body.
What and in Whom Is the Prevalence of Hepatic Hemangiomas?
Hepatic hemangiomas are the most common in the age group of 30 to 50 years but they can happen at any age, can occur more commonly in adults, often in women than men, and in some cases can affect both equally. They are non-cancerous tumors of the liver, mostly harmless, affecting around 5 % of the adult population in the US.
What Causes Hepatic Hemangiomas?
The cause of hepatic hemangiomas remains unknown; some may be due to genetics (that runs in the family, which is an unknown cause). In most cases, they are discovered during imaging of some other condition. They rarely show any symptoms and need treatment.
It usually occurs as a single collection of blood vessels that is less than 4 cm wide. Occasionally they are larger, but it is rare and is seen in children.
Which Factors Increase the Risk of Hepatic Hemangioma?
The Risk factors of hepatic hemangioma are:
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Age: This condition can be diagnosed at any age but most commonly in the 30 to 50 years of age group.
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Sex: Women are more prone to this condition than men.
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Hormone Replacement Therapy: Individuals who use hormone replacement therapy for menopausal symptoms are diagnosed with hepatic hemangiomas.
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Pregnancy: Pregnant women are prone to be diagnosed with hepatic hemangioma. The hormone estrogen is believed to be responsible; this may rise during pregnancy and play a key role in the growth of hepatic hemangioma.
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Estrogen Therapy: Excess use of oral contraceptives and ovarian stimulation treatment are therapies that can risk increasing hemangiomas in females.
What Are the Signs and Symptoms of Hepatic Hemangioma?
In most cases, they are asymptomatic. When they start growing in size, they may give certain signs and symptoms like:
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Nausea.
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Vomiting.
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Malaise.
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Loss of appetite.
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Decreased appetite.
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Discomfort and ache in the upper right side of the abdomen.
How Is the Diagnosis Made for Hepatic Hemangioma?
Hepatic hemangiomas are not identified through routine check-ups or testing; they can be accidentally diagnosed from imaging tests done for different conditions.
After the identification of the hemangiomas, the further diagnostic tests that are advised are:
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CT Scan (Computed Tomography) - X-rays are used to produce images of the tissues of the body.
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MRI (Magnetic Resonance Imaging) - Radio waves and a large magnet are used to produce images of bodily tissues.
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Contrast-enhanced Ultrasound - High-frequency sound waves are passed across the body, and echoes are recorded and transformed into images.
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Angiography - Contrast X-ray is used and inserted in the vessel of the body and reflected in imaging.
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Scintigraphy - A nuclear scan that uses radioactive trace material to form an image, substances like technetium-99m are used.
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Some are diagnosed at birth and as an infant. Mostly, they decrease in size over time and may disappear in rare cases.
What Is the Treatment and Management of Hepatic Hemangiomas?
Monitoring asymptomatic hemangiomas are the first line of treatment for cases where there is no sign or symptom. This monitoring can be done with imaging tests for 6 to 12 months. No specific drug treatment is there for hepatic hemangioma. Surgery is done if the hemangiomas have significant growth and discomfort, and pain.
Arterial embolization is a technique in which obstruction is created in blood vessels that give blood supply to hemangioma; this will slow, restrict and reverse the growth of the hemangioma.
In some cases, healthcare providers may tie off the artery supplying blood to hemangioma. This technique is hepatic artery ligation. Surrounding structures in the liver do not get affected by this; they get the required blood supply from other arteries and remain unaffected.
Liver transplantation in rare cases may be required. An indication of this procedure is when the hemangioma is extremely large or has multiple hemangiomas and cannot be treated with other techniques.
What Are the Complications Associated With Hepatic Hemangioma?
Hepatic hemangiomas can rarely cause any complications. However, when they increase in the size, they may lead to the following conditions:
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Severe abdominal pain.
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Liver damage.
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Extremely enlarged hemangioma.
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Bleeding inside the hemangioma or outside the hemangioma into the abdominal cavity.
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Rupture due to any kind of physical trauma.
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Compression due to enlarged hemangioma can have a pushing effect on the adjacent organs like the stomach, bile ducts, and live capsule. This can cause feelings of fullness, jaundice, and even pain.
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A degenerative complication of blood can clot inside hemangioma, and calcification can develop, which may lead to scar tissue.
Conclusion:
Hepatic hemangioma is a benign tumor that is mostly harmless and asymptomatic. The cause of this hemangioma is unknown; thus, the prevention of this condition is not possible. Most cases are identified during the diagnosis of other diseased conditions. It is upsetting to have a mass on the liver, though it is not harmful and has no symptoms, and causes no discomfort. There has been no such evidence of an untreated or undiagnosed hemangioma that has led to a serious consequence or any liver cancer.
