title: Giant hepatic hemangioma versus conventional hepatic hemangioma: clinical findings, risk factors, and management.
abstract: BACKGROUND
  Giant hepatic hemangiomas (GHHs) are those that are larger than 4 cm in size.
  
  
  OBJECTIVE
  The aim of this study was to describe GHH clinical findings, their risk factors, diagnostic approach and management, and to compare these data with those of conventional hemangiomas.
  
  
  METHODS
  We performed a retrospective analysis of patients diagnosed with hemangiomas, whether by imaging studies or histopathology, at our hospital within the time frame of 1990-2008. The medical records of each patient were reviewed to obtain clinical and surgical data.
  
  
  RESULTS
  Of the 57 patients with liver hemangioma, 41 (72%) were women and 32 (56%) had GHH. Liver hemangioma median size was 4.49 cm. In regard to the patients with GHH, 31.2% were asymptomatic and when symptoms presented, pain was the most common. Both symptoms and oral contraceptive exposure were more common in the GHH patients. Nine patients with GHH underwent surgery: 2 open biopsies due to diagnostic uncertainty, one enucleation, and 6 resections.
  
  
  CONCLUSIONS
  GHHs are more prevalent in women and when symptomatic, pain is the most frequent complaint. Diagnosis is usually made through imaging studies, but when there is diagnostic doubt, surgical exploration is sometimes needed. Oral contraceptive use is most likely more of a risk factor for GHH than for conventional hemangioma, but this association needs to be studied further.
authors.affiliation: Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Secretaría de Salubridad y Asistencia, México D.F., México.
authors.forename: C
authors.initials: C
authors.lastname: Moctezuma-Velázquez
authors.affiliation: Gastroenterología y Endoscopia, Hospital Ángeles Acoxpa, México City, México D.F., México.
authors.forename: G
authors.initials: G
authors.lastname: López-Arce
authors.affiliation: Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Secretaría de Salubridad y Asistencia, México D.F., México.
authors.forename: L A
authors.initials: LA
authors.lastname: Martínez-Rodríguez
authors.affiliation: Departamento de Gastroenterología, Hospital Ángeles Acoxpa, México D. F., México.
authors.forename: C
authors.initials: C
authors.lastname: Escalona-Huerta
authors.affiliation: Departamento de Gastroenterología, Hospital Ángeles Acoxpa, México D. F., México.
authors.forename: M
authors.initials: M
authors.lastname: Chapa-Ibargüengoitia
authors.affiliation: Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Secretaría de Salubridad y Asistencia, México D.F., México. Electronic address: detoal@yahoo.com.
authors.forename: A
authors.initials: A
authors.lastname: Torre
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D006391:Hemangioma / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Anticonceptivo oral; Enucleación; Enucleation; Hemangioma hepático; Hepatic hemangioma; Hepatic resection; Oral contraceptives; Resección hepática