title: Is regular follow-up scan for giant liver haemangioma necessary?
abstract: OBJECTIVE
  To review the reliability of radiological diagnosis and need of regular scans for giant liver haemangioma, in terms of long-term outcome and management options.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Division of Hepato-biliary and Pancreatic Surgery, Prince of Wales Hospital, Hong Kong.
  
  
  METHODS
  Patients with giant liver haemangioma noted on initial imaging from February 1996 to July 2006.
  
  
  METHODS
  Patient demographics, clinical assessments, management, and outcomes.
  
  
  RESULTS
  There were 42 female and 22 male patients with a median age of 49 (range, 27-84) years with a suspected haemangioma. The median maximal diameter of the lesions was 5.5 cm (range, 4.0-20.3 cm). They were first detected by ultrasonography (n=45), contrast-enhanced computed tomographic scan (n=18), or magnetic resonance imaging (n=1). Besides regular follow-up scans, 22 patients were investigated further to confirm the diagnosis/exclude malignancy. Finally, 63 patients had a haemangioma and one had a hepatocellular carcinoma. Regarding the patients with haemangiomas, two were operated on for relief of pain and the rest were managed conservatively. The median duration of follow-up was 34 months. Most (54%) of the patients were asymptomatic, but in 17% the haemangioma enlarged to exceed its original size by more than 20%. There were no haemangioma-associated complications.
  
  
  CONCLUSIONS
  Majority of patients having giant liver haemangioma are asymptomatic and do not suffer complications. If the diagnosis is uncertain, selective further investigations may be necessary. Lesions with a confirmed diagnosis tend to remain static in size; performing regular scans for asymptomatic giant liver haemangiomas may not be necessary.
authors.affiliation: Division of Hepato-biliary and Pancreatic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
authors.forename: Wilson W C
authors.initials: WW
authors.lastname: Ng
authors.forename: Y S
authors.initials: YS
authors.lastname: Cheung
authors.forename: K F
authors.initials: KF
authors.lastname: Lee
authors.forename: John
authors.initials: J
authors.lastname: Wong
authors.forename: Simon C H
authors.initials: SC
authors.lastname: Yu
authors.forename: Paul S F
authors.initials: PS
authors.lastname: Lee
authors.forename: Paul B S
authors.initials: PB
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000000981:diagnostic imaging*; D006723:Hong Kong; D006761:Hospitals; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography