Cavernous Hemangioma of the Liver
Cavernous hemangioma of the liver is commonly seen in middle-aged women. It is frequently solitary but can also occur in multiple forms, with a similar incidence in the left and right liver lobes. The tumor grows slowly, with a disease course that can span several years. Small tumors are typically asymptomatic, while larger tumors may cause upper abdominal discomfort, bloating, belching, and abdominal pain.
Physical examination may reveal an abdominal mass connected to the liver, characterized by a smooth surface, soft texture, a cystic consistency, and varying degrees of compressibility. Diagnosis is generally straightforward, based on clinical presentation in combination with imaging examinations such as ultrasonography, CT, MRI, or hepatic arteriography.
Surgical resection is the most effective treatment for cavernous hemangioma of the liver. However, small, asymptomatic hemangiomas do not require treatment and can be monitored with ultrasonography every 6 to 12 months to observe any changes over time. Patients with significant clinical symptoms that impact daily life and work, tumors with a diameter exceeding 10 cm, or lesions located near the liver margin with a risk of traumatic rupture may undergo surgical resection. Generally, the tumor is excised intact by separating it from its capsule, with efforts to preserve normal liver tissue. Partial liver resection or anatomic hepatectomy may be performed if necessary. For widespread lesions affecting both the left and right hepatic lobes, where resection is not feasible, hepatic artery ligation may be considered.
The most dangerous complication of cavernous hemangioma is massive hemorrhage caused by tumor rupture, though this is extremely rare.
Other Benign Liver Tumors
Other benign liver tumors, such as hepatic adenoma, hemangioendothelioma, biliary cystadenoma, lipoma, and neurofibroma, are rare. Surgical resection is the effective treatment for these conditions.