Case Report
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Surg. Nov 27, 2012; 4(11): 262-266
Published online Nov 27, 2012. doi: 10.4240/wjgs.v4.i11.262
Recurrent giant hemangiomas of liver: Report of two rare cases with literature review
Hongfa Zhu, Khaled Obeidat, Jie Ouyang, Sasan Roayaie, Myron E Schwartz, Swan N Thung
Hongfa Zhu, Jie Ouyang, Swan N Thung, The Lillian and Henry M Stratton-Hans Popper Department of Pathology, Mount Sinai Medical Center, New York, NY 10029, United States
Khaled Obeidat, Sasan Roayaie, Myron E Schwartz, Division of Surgical Oncology, Department of Surgery, The Mount Sinai Medical Center, New York, NY 10029, United States
Author contributions: Zhu H, Ouyang J and Thung SN were major contributors of data collection and manuscript preparation; Obeidat K, Roayaie S and Schwartz ME performed surgery and provided clinical information.
Correspondence to: Hongfa Zhu, MD, PhD, The Lillian and Henry M Stratton-Hans Popper Department of Pathology, Mount Sinai Medical Center, New York, NY 10029, United States. hongfa.zhu@mountsinai.org
Telephone: +1-212-2414226 Fax: +1-212-8284188
Received: May 1, 2012
Revised: September 9, 2012
Accepted: November 1, 2012
Published online: November 27, 2012
Abstract

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.

Keywords: Liver; Giant hemangioma; Recurrent hemangioma