IS Case 5: Hepatic Cavernous Hemangioma

Scott Cassar, MD

Imaging Sciences URMC

Imaging Sciences URMC 2008
Publication Date: 2009-05-18

History

A 76-year-old female with acute chest pain, tachycardia, and shortness of breath. Contrast enhanced CT revealed bilateral pulmonary emboli. This hepatic lesion was incidentally found and later evaluated with MRI.

Diagnosis

Hepatic Cavernous Hemangioma Differential includes peripheral (intrahepatic) cholangiocarcinoma and hypervascular metastases.

Discussion

A hepatic cavernous hemangioma is the most common benign tumor of the liver. Histologically, it is a well-circumscribed mass of blood-filled spaces lined by a single layer of endothelial cells on thin, fibrous stroma. Most hemangiomas are solitary and peripherally located. They occur sporadically and are usually asymptomatic.

Hemangiomas are well-circumscribed, round or lobular lesions, with the following MR imaging characteristics:

* T1WI - hypointense to liver parenchyma * T2WI - hyperintense to liver and spleen parenchyma * Dynamic contrast enhanced imaging (3 enhancement patterns): o immediate uniform enhancement o peripheral enhancement with centripetal progression to uniform enhancement o peripheral nodular enhancement with centripetal progression but persistent central hypointensity

References

  1. Federle, Michael P. Hepatic cavernous hemangioma. 9/21/2006. https://my.statdx.com.
  2. Siegelman, Evan S. Body MRI. pps 21-26. Elsevier Sauders, Philadelphia. .2005.

5 images