Liver hemangiomas (also referred to as hepatic hemangiomas) are a common type of growth within the liver. They are benign, which means that they are not cancerous, and most people who have liver hemangiomas are not likely to experience any symptoms. However, even though they are benign, it is important to understand this condition because large liver hemangiomas can cause significant discomfort, an array of harmful symptoms, and can sometimes be fatal. In severe cases, these tumors require complex surgical intervention. Various imaging technologies can be used to identify liver hemangiomas, though some are better at diagnosing them than others. This article will cover what liver hemangiomas are, what symptoms they can trigger, what causes them, and how they are detected and diagnosed.
Liver hemangiomas are defined medically as benign tumors of the liver consisting of a clump of blood-filled cavities or tangled blood vessels fed by the hepatic artery (the major blood vessel of the liver). The cavities are lined by a single layer of endothelial cells, which also make up the inner lining of blood vessels. Liver hemangiomas are the most common type of benign liver tumor and occur in approximately five percent of the population.
Most liver hemangiomas don’t exceed 5 cm in diameter and exhibit very slow growth rates (if they grow at all). Liver hemangiomas that exceed 5 cm are considered “giant,” and sizes exceeding 40 cm have been described in the medical literature. Most liver hemangiomas do not cause any symptoms, but as they grow, symptoms are more likely to emerge. In some cases, hemangiomas undergo rapid growth and require swift medical intervention.
Liver hemangiomas can emerge in individuals of any age and can be present from birth. However, they are more common in adults aged between 30 and 50 and occur more frequently in women than in men. A study found that adults in their twenties have a lower incidence than other groups, and their liver hemangiomas are more likely to be smaller. The study also found that liver hemangiomas exhibited slower growth rates as individuals age.
While most liver hemangiomas don’t cause symptoms, larger tumors can cause a diverse set of symptoms depending on the individual. Common symptoms include upper right abdominal pain, nausea, vomiting, and a feeling of fullness after eating small amounts of food. These symptoms can be caused by a wide range of other health issues, which makes it challenging to diagnose liver hemangiomas based on symptoms alone.
As these benign tumors grow, there is an increased risk of more severe health problems and complications. Large hemangiomas can put physical pressure on nearby organs and can rupture, leading to internal bleeding, which carries a high mortality rate. Liver hemangiomas can also cause fever and jaundice in some cases. Complications such as internal bleeding are considered severe health emergencies and require immediate medical care to be properly resolved. If left untreated, these complications can be life-threatening, making timely detection and intervention crucial for patient outcomes.
It's important to recognize the symptoms of liver hemangiomas, so you can seek medical advice when needed. If you experience persistent pain, particularly in the upper right abdomen, or other worrying symptoms, you should contact a healthcare professional immediately.
To this day, the exact cause of liver hemangiomas is unknown. However, the incidence of these tumors offers some clues into how they emerge. Genetic factors are thought to play a role in some individuals. For instance, individuals with Beckwith-Wiedemann syndrome (BWS), a rare genetic condition that affects how certain parts of the body grow, could be more prone to developing liver hemangiomas and other benign tumors. Liver hemangiomas develop due to various factors unique to each person, meaning there is no single cause for these tumors.
There are several risk factors that increase the likelihood of developing liver hemangiomas, including age, which we mentioned previously. The higher prevalence of these tumors in women is often linked to pregnancy and estrogen therapies, as exposure to female sex hormones is considered a risk factor.
In many cases, individuals are born with liver hemangiomas. Sometimes, these tumors are fully grown, while others grow slowly throughout the individual's lifetime. These tumors are clinically distinguishable from those that emerge after birth and may require continuous monitoring over time. They are categorized into three types, broadly based on the extent to which the hemangioma involutes (shrinks) after birth. Congenital liver hemangiomas can cause severe health issues, such as jaundice and heart failure. In some cases, surgery is required to remove these tumors. In others, embolization, which is a procedure to block blood flow to the tumor, is employed.
Since liver hemangiomas are usually asymptomatic, they are commonly found incidentally during imaging tests like ultrasounds, computed tomography (CT), and magnetic resonance imaging (MRI) scans. Ultrasound is used to monitor lesions in the liver and to track the progression of liver disease. It uses sound waves to create images of internal body structures. CT scans can detect lesions and liver disease and are often used as an investigational tool to determine the cause of symptoms like abdominal pain. Similarly, liver MRIs help to detect a variety of liver issues, including tumors. The altered blood flow within hemangiomas compared to malignant tumors and healthy tissue is important for their diagnosis and can be assessed with different imaging techniques. More specifically, blood flow within liver hemangiomas is typically slower compared to normal blood vessels.
Liver hemangiomas appear darker on CT scans compared to adjacent liver tissue. They can be differentiated from malignant liver tumors due to distinct signaling patterns when a contrast agent is added to the bloodstream and by the lack of a dark “rim” surrounding the mass. With MRIs, hemangiomas display different T2-weighted signal intensities compared to malignant tumors. T2-weighted images make certain things like fluid (water) in the body appear bright, and fat or dense tissue appear darker. In general, MRIs are a primary tool used to diagnose liver hemangiomas, even in cases where they have been originally observed with ultrasound or CT.
Liver hemangiomas are benign and often asymptomatic, but understanding their characteristics, potential symptoms, and risk factors is crucial. While most individuals with these growths will not require treatment, larger hemangiomas can cause discomfort or lead to severe complications, such as internal bleeding. Early detection and diagnosis through imaging techniques like CT or MRI are essential for differentiating these benign tumors from more serious liver conditions. If symptoms arise, timely medical intervention is critical to manage any risks associated with these tumors and ensure better patient outcomes. It’s essential to consult with a trusted healthcare provider if worrying symptoms appear.
Booking an Ezra Full Body Scan is a fantastic way to be proactive about your long-term health. Scans can help identify potential problems early, giving you time to take corrective action.
