Does the psychological request of the patient justify the surgery for hepatic hemangioma?
OBJECTIVE
The incidental finding of hemangiomas has increased, but the problem of the correct surgical indications of this tumor has yet to be solved. The aim of this work is to establish whether the psychological request of surgery from patients known to have a benign tumor of the liver must be avoided or not.


METHODS
Age, sex, symptoms, estroprogestinic oral therapy, methods of diagnosis, surgical procedures, morbidity, mortality, postoperative hospital stay and follow-up of the patients affected by hepatic hemangioma, observed from 1992 to 2002 in our institution, have been considered.


RESULTS
Seventeen patients, with a mean age of 44 years (range 26-72), were hospitalized for hepatic hemangioma, 8 (47%) of them were operated on and 9 (53%) were managed by observation. The operated patients presented various symptoms. One patient was operated on for traumatic rupture of the hemangioma. Non-operated patients were asymptomatic or with slight dyspeptic symptoms not related with the tumor. The first diagnostic radiological examination was ultrasonography (US) in all cases. All lesions were larger than 4cm. The types of surgical procedures were 5 enucleations, and 3 hepatic resections. All operated patients resolved their clinical symptomatology, except two patients that had requested surgery for psychological implications. These patients presented their symptoms again after 2and 3 years of follow-up respectively.


CONCLUSIONS
Our results suggest that liver hemangiomas should be operated for symptoms well related to the tumor or for bleeding. Psychological requests from the patients should be avoided every time.
Di Carlo
Isidoro
I
Department of Surgical Sciences, Organ Transplantation and Advanced Technologies University of Catania, Cannizzaro Hospital, Catania, Italy. idicarlo@unict.it
Sofia
Maria
M
Toro
Adriana
A
D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006392:Hemangioma, Cavernous / Q000175:diagnosis / Q000401:mortality / Q000523:psychology* / Q000601:surgery; D006498:Hepatectomy / Q000523:psychology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019370:Observation; D012307:Risk Factors; D012803:Sick Role; D016019:Survival Analysis; D016896:Treatment Outcome