• Benign liver tumor
• Hepatic adenoma
• Hepatic epithelioid hemangioendothelioma
• Hepatic hemangioma
• Liver adenomatosis
• Liver transplantation

• 3D image reconstruction
• Giant
• Hepatic hemangioma
• Surgical indication
• Surgical management
• Surgical technique

• Enucleation
• Giant Hepatic Haemangioma
• Kasabach-Merritt Syndrome
• Liver Resection

Hepatic hemangioma (HH) is the most common benign tumor of the liver. In special conditions such as rapidly growing tumors, persistent pain, hemorrhage and when pressure effect on adjacent organs exist treatment is indicated. Surgical management is the most common treatment for HH.

A 38-year-old male patient was diagnosed with HH for 7 years. The initial presentation of the mass was progressive abdominal distention causing early satiety, gastro-esophageal reflux disease, vomiting, dysphagia and weight loss. Later, the patient developed bilateral lower extremity edema. Imaging with computed tomography (CT scan) showed a large mass measuring 32.4*26*3.1 cm which was considered unresectable. The patient underwent a deceased donor liver transplantation. The excised mass was 9 kg. After nine days of hospitalization the patient was discharged in good condition. Three months later, the patient was admitted due to fever and cytomegalovirus infection for which he received intravenous ganciclovir and was discharged. In the latest follow-up the patient had no liver or kidney dysfunction eight months after the transplantation.

With appropriate patient selection, liver transplantation can be considered as a treatment option for patients with huge HHs which are life-threatening and surgically unresectable.

• Benign liver neoplasms
• Cavernous Hemangioma
• Hepatic Hemangioma
• Liver transplantation

• Hepatic hemangiomas
• microwave ablation
• outcome comparison
• safety and effectiveness
• surgical resection

• Giant hepatic hemangioma
• efficacy
• microwave ablation
• safety
• ultrasound-guided

Hepatic hemangioma represents the most common benign primary hepatic neoplasm. Although most such tumors are small and asymptomatic, giant hepatic hemangioma is frequently symptomatic, and requires intervention. Moreover, diffuse multiple hepatic hemangiomatosis occupying almost the entire liver is extremely rare in adults, and the optimal management for this condition is unclear. We report a case of a rapidly growing, symptomatic giant hepatic hemangioma with diffuse hepatic hemangiomatosis in a 50-year-old female patient who was treated by living-donor liver transplantation. This case shows malignant behavior of a benign hemangioma that required liver transplantation. Although this case could not meet the criteria for transplantation according to the MELD (model for end-stage liver disease) score system, it should be considered as an exceptional indication for deceased-donor liver allocation. Further studies of the mechanism underlying hemangioma growth are warranted.

• Hemangiomatosis
• Hepatic neoplasm
• Liver transplantation
• Hemangioma

In liver haemangiomas, the risk of complication rises with increasing size, and treatment can be obligatory. Here we present a case of a 46-year-old female who suffered from a giant haemangioma causing severe portal hypertension and vena cava compression, leading to therapy refractory ascites, hyponatremia and venostasis-associated thrombosis with pulmonary embolism. The patients did not experience tumour rupture or consumptive coagulopathy. Surgical resection was impossible because of steatosis of the non-affected liver. Orthotopic liver transplantation was identified as the only treatment option. The patient’s renal function remained stable even though progressive morbidity and organ allocation were improbable according to the patient’s lab model for end-stage liver disease (labMELD) score. Therefore, non-standard exception status was approved by the European organ allocation network “Eurotransplant”. The patient underwent successful orthotopic liver transplantation 16 mo after admission to our centre. Our case report indicates the underrepresentation of morbidity associated with refractory ascites in the labMELD-based transplant allocation system, and it indicates the necessity of promptly applying for non-standard exception status to enable transplantation in patients with a severe clinical condition but low labMELD score. Our case highlights the fact that liver transplantation should be considered early in patients with non-resectable, symptomatic benign liver tumours.

• Giant haemangioma
• Therapy refractory ascites
• Orthotopic liver transplantation
• Non-standard exception status
• Lab model for end-stage liver disease -based allocation system

• complication
• efficacy
• hepatic hemangioma
• microwave ablation

Hemangioma is the most common type of benign tumor that arises in the liver. Although rupture and hemorrhage of hepatic hemangioma are rare complications, they can be the cause of mortality. The authors report a case of hemorrhagic hepatic hemangioma: in a 54-year-old woman who was admitted with epigastric pain. She had taken oral contraceptives several weeks prior. The results of a blood examination were normal. An abdominal computed tomography scan revealed a tumor in hepatic segment 4, and a hemorrhage inside the cystic mass was suspected. The mass was removed laparoscopically to confirm the tumor properties and control the hemorrhage. The pathologic findings of the resected mass were consistent with hepatic hemangioma with intratumoral hemorrhage. The patient was discharged 8 d after the surgery, without further complications or complaints, and the patient’s condition was found to have improved during follow-up.

• Hemangioma
• Liver
• Hemorrhage
• Tumor
• Complication

• Abdominal Pain/etiology
• Biopsy
• Female
• Hemangioma/complications
• Hemangioma/pathology
• Hemangioma/surgery
• Hemorrhage/etiology
• Hepatectomy
• Humans
• Liver Neoplasms/complications
• Liver Neoplasms/pathology
• Liver Neoplasms/surgery
• Middle Aged
• Rupture, Spontaneous
• Tomography, X-Ray Computed
• Treatment Outcome
• Ultrasonography, Doppler

• Kasabach-Meritt syndrome
• hepatic venous malformation
• living donor liver transplantation
• pediatric liver transplantation

Hepatic hemangiomas are the most common benign tumor of the liver. Most hepatic hemangiomas remain asymptomatic and require no treatment. Giant hepatic hemangiomas with established complications, diagnostic uncertainty and incapacitating symptoms, however, are generally considered an absolute indication for surgical resection. We present a case of a giant hemangioma with intestinal obstruction following transcatheter arterial embolization, by which the volume of the hemangioma was significantly reduced, and it was completely resected by a left hepatectomy. A 21-year-old Asian man visited our hospital for left upper quadrant pain. Examinations at the first visit revealed a left liver hemangioma occupying the abdominal cavity, with a maximum diameter of 31.5 cm. Embolization of the left hepatic artery was performed and confirmed a decrease in its size. However, the patient was readmitted to our hospital one month after embolization for intestinal obstruction. A left hepatectomy was completed through a herringbone incision, and safely removed a giant hemangioma of 26.5 cm × 19.5 cm × 12.0 cm in size and 3690 g in weight. Pre-operative arterial embolization is effective for reducing tumor size, but a close follow-up to decide the time for hepatectomy is important.

• Hepatic hemangioma
• Transcatheter arterial embolization
• Intestinal obstruction
• Complications
• Hepatectomy

• Embolization, Therapeutic
• Hemangioma/complications
• Hemangioma/pathology
• Hemangioma/surgery
• Hemangioma/therapy
• Hepatectomy
• Humans
• Intestinal Obstruction/diagnosis
• Intestinal Obstruction/etiology
• Liver Neoplasms/complications
• Liver Neoplasms/pathology
• Liver Neoplasms/surgery
• Liver Neoplasms/therapy
• Magnetic Resonance Imaging
• Male
• Predictive Value of Tests
• Time Factors
• Tomography, X-Ray Computed
• Treatment Outcome
• Tumor Burden
• Young Adult

Most hepatic hemangiomas (HHs) are small, asymptomatic and do not require clinical intervention. Surgical resection is only indicated for symptomatic hemangiomas. We report here cases of recurrent HHs in 2 women of 37 and 40 years old, who initially presented with abdominal pain and mass. Radiological examination of each tumor revealed a solitary tumor of 14 and 20 cm in diameter, respectively. Surgical liver segmental resections were performed in both, and the diagnosis of cavernous hemangioma was confirmed. Both patients had recurrent tumor on subsequent radiological examination 4-5 years after the initial surgery. In the first patient, a 15 cm recurrent hemangioma was resected, but multiple hemangiomas were again detected 8 years later occupying the other hepatic lobe, which was not amendable for resection. In the second patient, a 16 cm hemangioma was seen on radiogram, and because the lesion was not symptomatic, conservative observation was offered. Recurrence after liver resection of giant hemangioma is extremely rare. The pathogenesis of tumor progression and recurrence is unknown, as is the management of these patients with recurrent hemangioma, particularly when it is extensive and unresectable.

• Liver
• Giant hemangioma
• Recurrent hemangioma

• Adult
• Aged
• Female
• Graft Survival
• Hepatitis/epidemiology
• Hepatitis/surgery
• Hospitals, University/statistics & numerical data
• Humans
• Liver Cirrhosis/epidemiology
• Liver Cirrhosis/surgery
• Liver Neoplasms/epidemiology
• Liver Neoplasms/surgery
• Liver Transplantation/methods
• Liver Transplantation/mortality
• Liver Transplantation/statistics & numerical data
• Male
• Middle Aged
• Poland/epidemiology
• Recurrence
• Reoperation
• Retrospective Studies
• Risk Assessment
• Survival Analysis
• Young Adult

• hepatic hemangioma
• kasabach-merritt syndrome
• liver transplantation

• Abdominal Cavity
• Adult
• Emergencies
• Female
• Hemangioma, Cavernous/complications
• Hemangioma, Cavernous/diagnosis
• Hemangioma, Cavernous/surgery
• Hemorrhage/etiology
• Hemorrhage/surgery
• Humans
• Liver Neoplasms/complications
• Liver Neoplasms/diagnosis
• Liver Transplantation/methods
• Tomography, X-Ray Computed

• Female
• Hemangioma, Cavernous/diagnosis
• Hemangioma, Cavernous/pathology
• Hemangioma, Cavernous/surgery
• Hepatectomy/methods
• Humans
• Middle Aged

• hemangioma
• hepatectomy
• kasabach-merritt
• budd-chiari