Liver Hemangioma in Older People - Causes, Symptoms, and Treatment

What Is Liver Hemangioma?

Liver hemangioma is defined as a benign, non-cancerous lump or mass of blood vessels found in the liver. These blood vessels are clustered together and malformed, and are supplied by the hepatic or liver artery. Liver hemangioma is also known as hepatic or cavernous hemangioma. Hemangiomas can occur in various organs, including the brain. In the brain, they can end up in severe complications. However, in the liver, they cause problems only if they grow large, which is very rare. Smaller hemangiomas do not present with any symptoms. Only large hemangiomas can cause symptoms like pain and discomfort. Liver hemangioma is more common in the 30 to 50 age group. However, it can also occur in people above 60 years.

What Are the Causes of Liver Hemangioma in Older People?

The exact cause of liver hemangioma is still unknown. Many researchers think it is congenital, meaning it is present from birth. Studies found that liver hemangioma runs in certain families and hence suggesting that there can be a genetic cause. However, the risk factors for liver hemangioma include people between 30 and 50 years of age and women who have undergone pregnancy or hormone replacement therapy.

Although alcohol can cause many liver problems, it cannot cause liver hemangioma. Some researchers believe that prolonged use of steroids for a medical condition or muscle building can accelerate the growth of hemangiomas.

What Are the Clinical Manifestations of Liver Hemangioma in Older People?

Many people with liver hemangioma have very small-sized and single hemangioma. It is very rare to have multiple and large-sized hemangiomas. In most cases, the size of hemangioma is 3 cm to 4 cm. They are called giant hemangiomas if their size is above 10 cm.

However, the following symptoms can appear if the size of the hemangioma is above 4 cm:

• Pain and discomfort in the right upper quadrant of the abdomen as the liver is located in this quadrant.

• Bloating.

• Nausea and vomiting.

• A feeling of fullness or lack of appetite.

These symptoms commonly occur when there is swelling or compression of the stomach due to liver hemangioma.

How Is Liver Hemangioma Diagnosed?

In most cases, it is incidentally diagnosed during imaging studies for other diseases. Following are the imaging studies that can diagnose liver hemangioma:

1. Ultrasound: Ultrasound scan captures images of organs with the help of high-frequency sound waves. Liver ultrasound is a type of transabdominal ultrasound. It can diagnose most liver conditions, including liver hemangioma.

2. Magnetic Resonance Imaging (MRI): MRI uses radio frequencies to convert energy from protons in the body to an image. It is a non-invasive technique and is expensive. MRI of the liver can depict any lesions or masses in the liver that can be cancerous or non-cancerous.

3. Computed Tomography (CT): A CT scan can show any body parts, including bones, muscles, fat, and organs. It uses X-rays and computer techniques to form images of the internal body parts.

4. Scintigraphy: It is a non-invasive method that uses radioactive trace material known as Technetium-99 to form images of the liver. Scintigraphy is very effective in diagnosing liver hemangioma.

How Is Liver Hemangioma Treated in Older Adults?

If the liver hemangioma is smaller in size, it doesn't require treatment in most cases. There is no evidence of liver hemangioma transforming into a tumor if it isn't treated. Patients with liver hemangiomas are kept under observation and may be advised for imaging tests once or twice a year to detect any growth in the mass. In many cases, it won't grow and can even regress in size over time. However, based on the size, location, and number, some liver hemangiomas can cause complications.

The treatment methods for liver hemangioma include:

• Medications: Corticosteroids are prescribed for the treatment of hemangiomas. It is found to be effective in treating large liver hemangiomas that produce congestive cardiac failure.

• Blocking the Blood Supply of Hemangiomas: The blood supply to the liver hemangiomas is blocked by tying the main artery of the liver, which is the hepatic artery. This method is known as hepatic artery ligation. Another way to block the hepatic artery is to inject medication into it. This method is called selective hepatic artery embolization. Blocking the blood supply to the hemangioma can shrink it.

• Surgical Removal: Surgery can be done to remove the liver hemangioma. In certain cases, a small part of the liver may and hemangioma have to be removed.

• Liver Transplantation: In cases where there is a large hemangioma or multiple hemangiomas, which cannot be treated by other methods, liver transplantation is recommended by the doctors. The liver with a hemangioma is removed and replaced with a liver from a donor.

• Radiation Therapy: In this treatment, X-rays or other powerful energy beams are used to destroy the cells of hemangioma. However, radiation therapy is less preferred because other safer and more effective methods exist.

What Are the Complications of Liver Hemangioma?

The complications of liver hemangioma are very rare. However, patients have to be cautious and seek medical help when they experience any kind of symptoms.

• The blood vessels present in liver hemangioma can rupture, resulting in a hemorrhage into the abdomen. This can lead to the accelerated formation of blood clots, causing life-threatening conditions like heart failure.

• A liver hemangioma can compress the blood vessels and bile duct, resulting in edema, thrombosis, or jaundice.

• Direct trauma or injury to the liver can sometimes rupture the hemangioma, causing severe internal bleeding. In some cases, large hemangiomas can also undergo rupture, resulting in severe bleeding.

• Degenerative complications of hemangioma include scar tissue, blood clots, nodules, and calcium deposits.

Conclusion

Liver hemangioma is a benign mass with malformed blood vessels formed in the liver. In many cases, it is harmless and does not cause any pain or discomfort to the person. Although people between 30 and 50 years of age are at higher risk, a liver hemangioma can occur in people above 60 as well. Generally, liver hemangiomas are diagnosed by accident during imaging studies for other conditions. However, in rare cases, it can lead to complications like internal bleeding or heart failure, which require immediate treatment. As the cause of liver hemangioma is unknown, there aren't any prevention strategies for liver hemangiomas.