Wang JZ, Chen H. Hepatic hemangiomas mimicking gastrointestinal stromal tumors: A case report. World J Clin Cases 2025; 13(11): 101668 [DOI: 10.12998/wjcc.v13.i11.101668]
Corresponding Author of This Article
Hao Chen, PhD, Professor, Department of Surgical Oncology, Oncology Center, Lanzhou University Second Hospital, No. 82 Cuiyingmen Road, Chengguan District, Lanzhou 730030, Gansu Province, China. ery_chenh@lzu.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Apr 16, 2025; 13(11): 101668 Published online Apr 16, 2025. doi: 10.12998/wjcc.v13.i11.101668
Hepatic hemangiomas mimicking gastrointestinal stromal tumors: A case report
Ji-Ze Wang, Hao Chen
Ji-Ze Wang, Hao Chen, Department of Surgical Oncology, Oncology Center, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
Author contributions: Wang JZ conceptualized and designed the study, collected data, analyzed statistics, wrote the manuscript, and reviewed and edited the manuscript; Chen H supervised the research project, coordinated the study, and approved the final manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Supported by the Natural Science Foundation of Gansu Province, No. 24JRRA347.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hao Chen, PhD, Professor, Department of Surgical Oncology, Oncology Center, Lanzhou University Second Hospital, No. 82 Cuiyingmen Road, Chengguan District, Lanzhou 730030, Gansu Province, China. ery_chenh@lzu.edu.cn
Received: September 22, 2024 Revised: November 19, 2024 Accepted: December 5, 2024 Published online: April 16, 2025 Processing time: 94 Days and 16.3 Hours
Abstract
BACKGROUND
Hepatic hemangiomas can be challenging to diagnose, particularly when they present with atypical features that mimic other conditions, such as gastrointestinal stromal tumors (GISTs). This case highlights the diagnostic difficulties encountered when imaging subepithelial lesions, especially when conventional methods such as computed tomography (CT) and endoscopic ultrasound (EUS) are used.
CASE SUMMARY
A 44-year-old woman presented with intermittent abdominal distension and heartburn for three months. Her medical history included iron deficiency anemia, menorrhagia, and previous cholecystectomy. One week prior to admission, an endoscopy suggested a bulging gastric fundus, which was likely a GIST, along with chronic nonatrophic gastritis and bile reflux. CT and EUS revealed nodules in the gastric fundus, which were initially considered benign tumors with a differential diagnosis of stromal tumor or leiomyoma. During surgery, unexpected lesions were found in the liver pressing against the gastric fundus, leading to laparoscopic liver resection. Postoperative pathology confirmed the diagnosis of hepatic cavernous hemangiomas. The patient recovered well and was discharged five days later, with normal follow-up results at three months.
CONCLUSION
This case underscores the challenges in the preoperative diagnosis of GISTs, particularly the limitations of the use of CT and EUS for the evaluation of subepithelial lesions. While CT is the primary tool for visualizing abdominal tumors, it is difficult to detect smaller lesions and assess the layers of the gastrointestinal wall on CT. EUS is recommended for the evaluation of nodules smaller than 2 cm and is useful for distinguishing GISTs from other lesions; however, its accuracy with regard to the differential diagnosis is relatively low. In this case, the gastric distension observed on imaging led to the compression of a liver tumor against the stomach, resulting in the misinterpretation of the tumor as a gastric wall lesion.
Core Tip: Hepatic hemangiomas can be challenging to diagnose, especially when they mimic other conditions like gastrointestinal stromal tumors. This case highlights the limitations of imaging techniques such as computerized tomography and endoscopic ultrasound in diagnosing subepithelial lesions. While computerized tomography is effective for visualizing abdominal tumors, it struggles to detect smaller lesions and assess the gastrointestinal wall layers. Endoscopic ultrasound is helpful for evaluating smaller nodules, but its diagnostic accuracy is limited. This case emphasizes the importance of considering hepatic lesions when gastrointestinal symptoms are present, particularly when imaging findings are inconclusive.
