title: A hepatic sclerosed hemangioma with significant morphological change over a period of 10 years: a case report.
abstract: BACKGROUND
  Liver cavernous hemangioma is the most common noncystic hepatic lesion, and a hemangioma that undergoes degeneration and fibrous replacement is called a hepatic sclerosed hemangioma.
  
  
  METHODS
  A 63-year-old Japanese man was admitted for detailed investigation of a liver tumor. Tumor markers carcinoembryonic antigen, alpha-fetoprotein, and CA19-9 levels in the peripheral blood were not elevated at any time. Plain computed tomography showed an approximately 1.5 cm low density mass in the periphery of segment 8, which was marginally enhanced on contrast-enhanced dynamic computed tomography. On magnetic resonance imaging, the tumor was hypointense on T1-weighted image and hyperintense on T2-weighted image. The tumor was suspected to be an atypical hemangioma, metastatic, hepatocellular carcinoma, or cholangiocellular carcinoma. Segmental hepatectomy was performed. Histological examination of the resected tumor specimen revealed a sclerosed hemangioma with marked hyalinization and sparse stromal fibrosis. Immunochemically, the tumor cells were positive for CD34 and alpha smooth muscle actin. Electron microscopically, the residual hemangioma consisted of numerous caveolae and vesicles in endothelial cells in irregular shapes and sizes. Immunostaining for caveolin-1 showed decreased or no caveolin-1 reactivity in the hyalinized lesions of the sclerosed hemangioma, but abundant caveolin-1 reactivity in the residual cavernous hemangioma. Of interest, computed tomography images of the tumor obtained 10 years earlier at our hospital depicted a 3 cm typical cavernous hemangioma.
  
  
  CONCLUSIONS
  Hepatic sclerosed hemangioma is a rare condition. Comparison of radiological findings of the lesion over a period of 10 years was valuable in providing insight for the evolutional process from liver cavernous hemangioma to hepatic sclerosed hemangioma.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Shimada
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Iguchi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yamazaki
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Tsunoda
authors.forename: Masaaki
authors.initials: M
authors.lastname: Watanabe
authors.forename: Masaya
authors.initials: M
authors.lastname: Oda
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Yokomori