Size of lesion is not a criterion for resection during management of giant liver haemangioma.
BACKGROUND
The unknown natural history and risk of complications of large haemangiomas may pose therapeutic dilemmas. The authors describe their experience with the management of giant haemangiomas.


METHODS
Patients with a giant haemangioma were identified by a survey of the hospital database. Forty-nine patients with a haemangioma of at least 4 cm in diameter presented between January 1990 and December 2000. Medical records were analysed retrospectively.


RESULTS
Eleven patients had surgical treatment and 38 were managed conservatively. The median diameter of the tumours was 8.0 cm in surgically treated patients and 6.0 cm in the group managed by observation. Surgery-related morbidity occurred in three patients, and abdominal complaints persisted in three of ten patients with a symptomatic lesion. During a median follow-up of 52 months, 12 non-operated patients had mild abdominal complaints, considered to be unrelated to the lesion. In these patients symptoms either diminished or became minimal during follow-up. Complications did not occur.


CONCLUSIONS
Observation of giant haemangiomas can be performed safely. The authors advocate resection of cavernous liver haemangiomas only in patients with persistent severe symptoms.
Terkivatan
T
T
Department of Surgery, University Hospital Rotterdam-Dijkzigt, Rotterdam, The Netherlands.
Vrijland
W W
WW
Den Hoed
P T
PT
De Man
R A
RA
Hussain
S M
SM
Tilanus
H W
HW
IJzermans
J N M
JN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006391:Hemangioma / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods