Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 27, 2023; 15(5): 707-714
Published online May 27, 2023. doi: 10.4254/wjh.v15.i5.707
Giant cavernous hemangioma of the liver with satellite nodules: Aspects on tumour/tissue interface: A case report
Anne Kristin Fischer, Karl Tobias Erich Beckurts, Reinhard Büttner, Uta Drebber
Anne Kristin Fischer, Institute of Pathology, University of Cologne, Köln 50937, North Rhine Westphalia, Germany
Karl Tobias Erich Beckurts, Visceral Surgery, Severinsklösterchen Hospital Cologne, Cologne 50678, North Rhine Westphalia, Germany
Reinhard Büttner, Uta Drebber, Institute of Pathology, University Hospital of Cologne, Cologne 50937, North Rhine Westphalia, Germany
Author contributions: Fischer AK designed, wrote and edited the manuscript; Drebber U made the final diagnosis; Beckurts KTE performed the operation and delivered clinical information; all authors discussed the results and contributed to the final manuscript.
Informed consent statement: Informed consent was obtained from the patient for the publication of his information and imaging.
Conflict-of-interest statement: All the authors do not have any conflicts to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Anne Kristin Fischer, MD, Doctor, Institute of Pathology, University of Cologne, Kerpener Street, Köln 50937, North Rhine Westphalia, Germany.
Received: September 1, 2022
Peer-review started: September 1, 2022
First decision: November 14, 2022
Revised: December 3, 2022
Accepted: April 18, 2023
Article in press: April 18, 2023
Published online: May 27, 2023

Giant hepatic cavernous hemangioma with multiple satellite nodules is a rare subtype of hepatic cavernous hemangioma, the most common vascular liver tumor. We report on a tumor with unusual histologic features: (1) Finger-like infiltration pattern; (2) lack of encapsulation; (3) blurred tumor/liver interface; and (4) massive satellitosis-referring to the article “Hepatic cavernous hemangioma: underrecognized associated histologic features”.


A 60-year-old man presented with increasing uncharacteristic abdominal discomfort and mildly elevated blood parameters of acute inflammation. Imaging revealed an unclear, giant liver tumor of the left liver lobe. A massive vascular tumor with extensive satellitosis broadly infiltrating the adjacent liver parenchyma was resected via hemihepatectomy of segments II/III. Histopathological diagnosis was giant hepatic cavernous hemangioma with multiple satellite nodules, featuring unusual characteristics hardly portrayed in the literature. Retrospectively, this particular morphology can explain the difficult pre- and perioperative diagnosis of a vascular liver tumor that is usually readily identifiable by modern imaging methods.


This case emphasizes the exact histological workup of tumor and tumor-induced parenchyma changes in radiologically unclassifiable liver tumors.

Keywords: Giant hepatic cavernous hemangioma, Satellite nodules, Tumour/liver interface, Vascular liver tumours, Preoperative imaging, Case report

Core Tip: This case highlights that attention to tumour/tissue boarders and knowledge about unusual perilesional parenchyma changes is not only of academic pathological interest, but has an important role in unclear preoperative imaging to discriminate between benign and malignant entities in interdisciplinary hepato-oncology and highly precise modern imaging techniques.