Adult hepatic cavernous hemangioma

Cavernous hemangioma is the most common benign tumor of the liver, and its incidental detection has grown with the widespread availability of noninvasive imaging techniques. We review historical perspectives and pathologic findings of this vascular tumor and survey the etiologic factors and clinical features of the cases reported in the literature. The relative merits are discussed of each diagnostic modality in differentiating hemangioma from other tumors, and a logical sequence of investigations is suggested. Radionuclide blood-pool scan and magnetic resonance imaging have emerged as the most accurate imaging modalities for the diagnosis. With the refinement of technique and equipment, percutaneous needle biopsy is now proved to be safe and may obviate the need of surgery in the few cases in which definitive histologic diagnosis is required. In the minority of cases in which treatment is indicated for symptoms, transcatheter hepatic arterial embolization is a nonsurgical option at some centers with the necessary facilities and expertise. Surgical resection is an effective treatment for symptomatic patients with low mortality and morbidity.