[Cavernous hemangioma of the liver and hepatic hemangiomatosis. Indications and results of the surgical resection].
BACKGROUND
Cavernous hemangioma is the most frequent focal liver lesion. It affects mainly women and may cause symptoms such as abdominal pain, mass, and early satiety, or complications such as heart failure or coagulopathy. There are several options for treatment in symptomatic patients. However, it seems that surgical resection is the only curative treatment.


OBJECTIVE
Evaluate indications and results of liver resection in patients with cavernous hemangiomas and hepatic hemangiomatosis.


METHODS
We conducted a retrospective analysis of clinical files of patients treated at the Instituto Nacional de Cancerología (INCan) and the Centro Médico ISSEMYM during a 8-year period. Epidemiological data as well as diagnostic work-up and treatment were analyzed.


RESULTS
From August 1995 to May 2003, 24 patients with liver hemangiomas were resected at both institutions. Twenty three were female (95.8%) and one, male (4.1%). Indications for surgery were presence of symptoms in 20 patients (83.3%), undefined diagnosis in three (12.5%), and rapid growth in one (4.1%). Most frequent symptoms were abdominal pain in 20 (83.3%) patients, followed by abdominal mass in five (20.8%), and early gastric satiety in four (16.6%). Abdominal computed tomography (CT) scan was the most frequent imaging study used in 22 patients (91.6%), followed by ultrasound in 20 (83.3%). Size of lesion ranged from 4-30 cm (X: 8.7 cm), 16 patients were submitted to formal liver resection (66.6%), and eight to enucleation (33.3%). Four patients presented operative complications (16.6%) that included postoperative bleeding in two (8.3%), fever in one (4.1%) and abdominal haematoma in one (4.1%). There was no operative mortality. Twenty two patients were asymptomatic at time of evaluation (91%).


CONCLUSIONS
This lesion affects mainly women, and presence of symptoms is the most common indication for treatment. Choice of surgical procedure to be carried out depends on location and morphology of the lesion. Liver resection or enucleation are safe forms of treatment that properly controlled symptomatology.
Martínez-González
María Nancy
MN
Departamento de Gastroenterología, Instituto Nacional de Cancerología, México, D.F.
Mondragón-Sánchez
Ricardo
R
Mondragón-Sánchez
Alejandro
A
Gómez-Gómez
Elvira
E
Garduño-López
Ana Lilia
AL
Bernal-Maldonado
Rigoberto
R
Oñate-Ocaña
Luis F
LF
Ruiz-Molina
Juan Manuel
JM
D000328:Adult; D005260:Female; D006392:Hemangioma, Cavernous / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome