Recently, the Department of Hepatobiliary and Pancreatic Surgery, Military Hospital 108 admitted a patient to the hospital because of an unusually large abdomen and a large liver hemangioma occupying most of the abdomen.
The patient is Mrs. NTH (46 years old, Thai Binh). The patient said that recently she had abdominal pain, bloating when eating or drinking, and thought she had gastritis or intestinal inflammation so she went to see a doctor.
After examining and performing some paraclinical tests, doctors diagnosed the patient with a giant hemangioma of the left liver, nearly 30 cm in size. The large liver tumor took up most of the abdominal cavity, causing pain and bloating.
Image of a large liver tumor covering most of the patient’s abdominal cavity. BVCC photo
Doctors from the Department of Hepatobiliary and Pancreatic Surgery performed surgery to remove the patient’s giant hemangioma. After surgery, the patient received intensive treatment to prevent liver failure and post-operative bleeding while also incorporating early eating and exercise.
Clinical and paraclinical developments improved well, the patient was discharged from the hospital in a stable manner on the 7th day after surgery, with no post-operative complications. The pathological result was cavernous hemangioma of the liver.
Symptoms of liver hemangioma
According to Dr. Le Trung Hieu, Department of Hepatobiliary and Pancreatic Surgery, Military Hospital 108, liver hemangioma has no obvious symptoms and is often discovered accidentally during a health check, liver ultrasound or CT scan. computer class.
Dr. Hieu said, when liver hemangioma grows to a large size, causing symptoms such as abdominal pain, bloating, etc., hepatectomy is needed. When a hemangioma is small in size or does not cause symptoms as above, the patient needs to be monitored with ultrasound every 2-3 months to monitor the growth of the tumor.
Dr. Hieu shared that in medical literature, most liver hemangiomas are asymptomatic and benign, with a diameter larger than 5 cm and can cause symptoms.
Abdominal pain is the most common clinical manifestation as a result of liver capsule retraction. Thrombocytopenia may occur due to platelet sequestration and destruction within the tumor (Kasabach-Merritt syndrome).
“With the advancement and widespread use of imaging diagnostic tools, asymptomatic hemangiomas are diagnosed earlier and more frequently. Most hemangiomas are detected in women (the ratio of women to men is 5 : 1) and commonly occurs between the ages of 30-50”, Dr. Hieu commented.
Causes of liver hemangioma
According to Dr. Hieu, the cause of liver hemangioma is unclear, it is considered a congenital vascular malformation and does not proliferate cells. Typically, hemangiomas are asymptomatic and are often discovered incidentally during diagnostic imaging, and are usually small, stable, and can be monitored periodically.
Large hemangiomas (diameter > 5 cm) may be asymptomatic or cause various symptoms or complications such as: abdominal pain, fever, jaundice, and rupture may be spontaneous or traumatic.
Giant liver hemangiomas are larger than 15 cm in size and have the risk of causing symptoms of intra-abdominal organ compression.
The giant liver hemangioma was removed by surgeons. BVCC photo
According to Dr. Hieu, treatment methods for liver hemangioma include: monitoring or surgical intervention. Some authors believe that most hepatic hemangiomas do not require treatment and only require monitoring through periodic imaging every 6 months or yearly to assess tumor progression over time.
“Surgery to treat large hemangiomas is safe and effective. Treatment depends on the surgeon’s experience, the patient’s condition, the function of the remaining liver, liver condition, size, quantity and location of the tumor.
One of the important things is to detect tumors early so they can be treated,” Dr. Hieu shared.
