Follow-up of patients at low risk for hepatic malignancy with a characteristic hemangioma at US.
OBJECTIVE
To determine the need for follow-up imaging in patients with a low risk of malignancy and with ultrasonographic (US) findings typical of hepatic hemangioma.


METHODS
A computer search of US reports completed between 1991 and 1994 helped identify 383 patients whose reports contained the word "hemangioma." One hundred eleven patients were excluded because the lesion's appearance was atypical (n = 16) or because the patients had a high risk of malignancy (prior history or current evidence of extrahepatic malignancy or chronic hepatic disease [n = 95]). Fifty-nine patients were excluded because they were lost to follow-up (n = 41) or had clinical follow-up of less than 2 years (n = 18). The conditions of the remaining 213 patients with typical-appearing hemangiomas and a low risk of malignancy were analyzed. One hundred twenty-one patients underwent imaging follow-up or histopathologic confirmation. Ninety-two had clinical follow-up of more than 2 years (mean, 46 months).


RESULTS
Of the 213 patients, four had benign lesions other than hemangiomas. One patient who subsequently developed a malignancy (neuroendocrine metastases from primary colonic carcinoma diagnosed 22 months after initial US) potentially had an early metastasis that was misdiagnosed as a hemangioma.


CONCLUSIONS
On the basis of these results, the authors no longer recommend follow-up studies in their patients with a low risk of malignancy and a typical-appearing hemangioma at US.
Leifer
D M
DM
Mallinckrodt Institute of Radiology, Washington University Medical Center, St Louis, MO 63110, USA.
Middleton
W D
WD
Teefey
S A
SA
Menias
C O
CO
Leahy
J R
JR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014463:Ultrasonography