Liver Hemangioma

Overview

What is a liver hemangioma?

A liver hemangioma, also known as a hepatic hemangioma, is a benign (non-cancerous) tumor in the liver that is made up of clusters of blood-filled cavities fed by the hepatic (liver) artery. Usually, a patient has only one hemangioma, but in some cases there may be more than one. Hemangiomas do not develop into cancer and do not spread to other areas of the body.

How common are liver hemangiomas?

Liver hemangioma is the most common benign (non-cancerous) liver tumor, affecting up to 5% of adults in the United States.

Who is affected by liver hemangiomas?

Liver hemangiomas are more common in adults than in children; the typical age at diagnosis is 30-50 years, but they can happen at any age. Liver hemangiomas occur more often in women than in men, but can affect both.

Symptoms and Causes

What causes a liver hemangioma?

The causes of liver hemangiomas are not known. Some cases may be genetic (runs in the family).

What are the symptoms of a liver hemangioma?

Most liver hemangiomas do not cause symptoms, and are only discovered when the patient is being seen for another, unrelated health condition.

Small (a few millimeters to 2 centimeters in diameter) and medium (2 to 5 centimeters) hemangiomas usually do not cause symptoms, but should be followed regularly by a doctor. Such monitoring is needed because about 10% of hemangiomas increase in size over time, for unknown reasons.

Giant liver hemangiomas (more than 10 centimeters) usually develop symptoms and complications that require treatment. Symptoms most often include upper abdominal pain, as the large mass presses against surrounding the liver tissue and capsule. Other symptoms include:

  • Poor appetite
  • Feeling full quickly when eating a meal
  • Nausea
  • Vomiting
  • Feeling bloated after eating

Diagnosis and Tests

How is a liver hemangioma diagnosed?

A liver hemangioma is not usually discovered during a routine physical exam or laboratory testing. Diagnosis usually results from imaging studies that are being done for a different condition.

The imaging techniques that can single out liver hemangioma from other types of tumors include:

  • Contrast-enhanced ultrasound (high-frequency sound waves are sent through body tissues and the echoes are recorded and transformed into video or photos)
  • Computed tomography (CT) (X-rays and computers produce images of a cross-section of the body)
  • Magnetic resonance imaging (MRI) (a large magnet, radio waves and a computer produce images)
  • Angiography (X-ray contrast to look at the blood vessels in the body)
  • Scintigraphy (a nuclear scan that uses a radioactive trace material called Technetium-99m to form an image of the hemangioma).

Some hemangiomas are diagnosed at birth or early childhood (in up to 5-10% of one-year-olds). The hemangioma will usually get smaller over the course of time, and might disappear in some cases.

Management and Treatment

How are liver hemangiomas treated?

If a liver hemangioma is small, stable and causes no symptoms, it can be monitored with imaging studies every six to 12 months.

There are no drug treatments for a liver hemangioma. Surgery may be needed to remove the hemangioma if it grows rapidly or causes significant discomfort or pain.

A technique called embolization, in which the blood vessels that feed the hemangioma are obstructed, can slow or reverse its growth.

What are the complications associated with a liver hemangioma?

Complications depend on the size and location of the hemangioma, and include:

  • Mechanical complications:
    • Rupture (spontaneous or from physical trauma)
    • Compression (pushing) against surrounding organs such as the stomach (leading to feelings of fullness soon after beginning a meal); bile ducts (leading to jaundice); or the liver capsule (which causes pain)
  • Bleeding complications, either inside the tumor, or outside the tumor into the abdominal cavity
  • Degenerative complications, such as blood clotting inside the hemangioma, or the development of calcifications (calcium deposits in the tumor) or scar tissue

Prevention

Can a liver hemangioma be prevented?

Since the cause of liver hemangiomas is not known, there is no way to prevent them.

Who is at risk of developing a liver hemangioma?

People who are greater risk for a liver hemangioma include:

  • Adults
  • Those who have used certain medications, such as steroids, for a long time
  • Females and factors associated with being female such as:
  • Those who use chemicals produced by sex hormones that may encourage the growth of a hemangioma

Last reviewed by a Cleveland Clinic medical professional on 08/23/2018.

References

  • American Liver Foundation. Benign Liver Tumors. (https://www.liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/benign-liver-tumors/) Accessed 8/24/2018.
  • Merck Manual Consumer Version. Hemangiomas of the Liver. (https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/tumors-of-the-liver/hemangiomas-of-the-liver) Accessed 8/24/2018.
  • Bajenaru N, Balaban V, Săvulescu F, et al. Hepatic hemangioma -review-. J Med Life. 2015; 8(Spec Issue): 4–11.

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