Published online May 27, 2023. doi: 10.4254/wjh.v15.i5.707
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.
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.