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A hepatic hemangioma is a common benign vascular liver lesion composed of clusters of blood-filled vascular spaces lined by endothelium and supported by fibrous septa.

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• It is the most common benign hepatic tumor.

Epidemiology

• Prevalence: Up to 7% in the general population.
• More common in women (F:M ≈ 5:1).
• Typically discovered incidentally between 30–50 years of age.
• Usually solitary, but can be multiple.

Pathophysiology

• Believed to be congenital vascular malformations, not true neoplasms.
• Histologically consist of large vascular spaces (cavernous) separated by fibrous tissue.

Clinical Features

• Asymptomatic in most cases.
• May cause right upper quadrant pain or fullness if large (>5 cm, termed giant hemangiomas).

Rare complications:

• Rupture (extremely rare).
• Kasabach–Merritt phenomenon (KMP) (hemangioma thrombocytopenia syndrome): thrombocytopenia and coagulopathy (very rare).

Radiology