Liver hemangioma

Classification according to ICD-10
D18.03	Hemangioma: hepatobiliary system and pancreas
ICD-10 online (WHO version 2019)

A liver hemangioma is a benign tumor of the liver . With a prevalence of up to 20% in the general population, it is the most common neoplasm of the liver and a frequent incidental finding on ultrasound of the abdomen . Complaints are rare, but can occur as the size of the diagnosis increases. From a diameter of approx. 5 cm (according to other sources: from 10 cm) one speaks of a giant hemangioma .

pathology

There are three types of liver hemangiomas. Capillary hemangiomas (type 1) are usually small (1–2 cm). Cavernous hemangiomas (type 2) are usually larger and appear lobed. The so-called giant hemangiomas mostly belong to type 3, which is characterized by scarred or thrombosed areas.

Diagnosis

Liver hemangioma on ultrasound. The top left is the B-scan , the remaining pictures show the iris diaphragm phenomenon at different times after the administration of contrast agent

In most cases, liver hemangiomas are diagnosed on abdominal ultrasound, often as an incidental finding. There they appear as rounded to oval, sharply delimited, hyperechoic structures. In duplex sonography , a supplying vessel can sometimes be shown. A reliable diagnosis can be achieved by means of contrast medium ultrasonography: Here, a centripetal filling (from outside to inside) of the hemangioma with contrast medium is shown. In the German-speaking world, this is also known as the iris diaphragm phenomenon. A diagnosis using CT or MRI is also possible.

therapy

Therapy is usually not required. Only in exceptional cases such as rapid increase in size, pain or displacement of neighboring organs can a treatment, e.g. B. in the form of a surgical resection may be required.

supporting documents

↑ ^a ^b ^c S. Baroud, N. Bastati, H. Prosch, W. Schima, A. Ba-Ssalamah: Benign focal liver lesions . In: The Radiologist . tape 51 , no. 8 , August 3, 2011, p. 688 , doi : 10.1007 / s00117-010-2127-1 .
Jump up ↑ Mirko D'Onofrio, Stefano Crosara, Riccardo De Robertis, Stefano Canestrini, Roberto Pozzi Mucelli: Contrast-Enhanced Ultrasound of Focal Liver Lesions . In: American Journal of Roentgenology . tape 205 , no. 1 , June 23, 2015, p. W56-W66 , doi : 10.2214 / AJR.14.14203 .
↑ H.-J. Gassel, I. Klein, U. Steger, M. Simon, A. Thiede: The cavernous liver hemangioma: Rational diagnosis and therapeutic approach . In: Visceral Surgery . tape 40 , no. 1 , February 1, 2005, p. 37-44 , doi : 10.1055 / s-2005-836314 .

[Baroud-1] S. Baroud, N. Bastati, H. Prosch, W. Schima, A. Ba-Ssalamah: Benign focal liver lesions . In: The Radiologist . tape 51 , no. 8 , August 3, 2011, p. 688 , doi : 10.1007 / s00117-010-2127-1 .

[2] Jump up ↑ Mirko D'Onofrio, Stefano Crosara, Riccardo De Robertis, Stefano Canestrini, Roberto Pozzi Mucelli: Contrast-Enhanced Ultrasound of Focal Liver Lesions . In: American Journal of Roentgenology . tape 205 , no. 1 , June 23, 2015, p. W56-W66 , doi : 10.2214 / AJR.14.14203 .

[3] H.-J. Gassel, I. Klein, U. Steger, M. Simon, A. Thiede: The cavernous liver hemangioma: Rational diagnosis and therapeutic approach . In: Visceral Surgery . tape 40 , no. 1 , February 1, 2005, p. 37-44 , doi : 10.1055 / s-2005-836314 .