title: What is changing in indications and treatment of hepatic hemangiomas. A review.
abstract: Hepatic cavernous hemangioma accounts for 73% of all benign liver tumors with a frequency of 0.4-7.3% at autopsy and is the second most common tumor seen in the liver after metastases. Patients affected by hemangioma usually have their tumor diagnosed by ultrasound abdominal examination for a not well defined pain, but pain persist after treatment of the hemangioma. The causes of pain can be various gastrointestinal pathologies including cholelithiasis and peptic ulcer disease.The malignant trasformation is practically inexistent. Different imaging modalities are used to diagnosis liver hemangioma including ultrasonography, computed tomography (CT), magnetic resonance (MR) imaging, and less frequently scintigraphy, positronemission tomography combined with CT (PET/CT) and angiography. Imaging-guided biopsy of hemangioma is usually not resorted to except in extremely atypical cases. The right indications for surgery remain rupture, intratumoral bleeding, Kasabach-Merritt syndrome and organ or vessels compression (gastric outlet obstruction, Budd-Chiari syndrome, etc.) represents the valid indication for surgery and at the same time they are all complications of the tumor itself. The size of the tumor do not represent a valid indication for treatment. Liver hemangiomas, when indication exist, have to be treated firstly by surgery (hepatic resection or enucleation, open, laproscopic or robotic), but in the recent years other therapies like liver transplantation, radiofrequency ablation, radiotherapy, trans-arterial embolization, and chemotherapy have been applied.
authors.affiliation: Department of Surgery, Taormina Hospital, Messina, Italy.
authors.forename: Adriana
authors.initials: A
authors.lastname: Toro
authors.affiliation: Department of Radiology, Hamad General Hospital, Doha Qatar.
authors.forename: Ahmed-Emad
authors.initials: AE
authors.lastname: Mahfouz
authors.affiliation: Hepatology Unit. Department of Medical and Pediatric Science, University of Catania, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Ardiri
authors.affiliation: International PhD Program in Neuropharmacology. University of Catania, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Malaguarnera
authors.affiliation: University of Catania; Research Center "The Great Senescence". Cannizzaro Hospital, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Malaguarnera
authors.affiliation: Department of Radiology PO Palmi, ASP 5 RC, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Loria
authors.affiliation: Hepatology Unit. Department of Medical and Pediatric Science, University of Catania, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Bertino
authors.affiliation: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania. Catania, Italy; Department of Radiology, Hamad General Hospital, Doha Qatar.
authors.forename: Isidoro
authors.initials: I
authors.lastname: Di Carlo
mesh_terms: D000792:Angiography; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017115:Catheter Ablation; D004621:Embolization, Therapeutic; D015637:Gated Blood-Pool Imaging; D006391:Hemangioma / Q000175:diagnosis / Q000628:therapy; D006392:Hemangioma, Cavernous / Q000175:diagnosis* / Q000628:therapy; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000628:therapy; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D015609:Organotechnetium Compounds; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D011878:Radiotherapy; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D000970:Antineoplastic Agents; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals