Indications for surgery in the treatment of hepatic hemangioma.
OBJECTIVE
Hepatic hemangiomas are controversial tumors, especially as far as treatment is concerned. This paper analyses a series of 26 cavernous hemangiomas of the liver diagnosed between 1982 and 1993.


METHODS
A descriptive study is made of cases, their treatment and subsequent follow-up averaging 5 years.


RESULTS
A preoperative diagnosis was made in 18 patients. Fifteen of the 26 patients underwent operation, and no deaths occurred. One patient with Kasabach-Merritt syndrome (3.8%) had complications due to rupture of the hemangioma. Postoperative complications were limited to two abscesses (13%). There were no recurrences in the follow-up (average 4.4 years). Three of the 15 surgery patients revealed residual hemangiomas. There were no complications in the 11 non-surgery patients (five of which had giant hemangiomas) during a follow-up averaging 5.9 years. One patient initially without pain and with a hemangioma of 7.4 cm became symptomatic, and the hemangioma grew to 9.6 cm; another patient with pain became asymptomatic, with no change in hemangioma size.


CONCLUSIONS
Most hemangiomas can be managed conservatively. Indication for surgery should be assessed in units with experience in liver surgery, where low morbidity and mortality rates can justify the intervention.
Moreno Egea
A
A
Digestive Surgery Department, Virgen de la Arrixaca Hospital, Murcia.
Del Pozo Rodriguez
M
M
Vicente Cantero
M
M
Abellan Atenza
J
J
D000328:Adult; D000368:Aged; D005260:Female; D006392:Hemangioma, Cavernous / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome