Hepatic Sclerosed Hemangioma: a case report and review of the literature.
BACKGROUND
Although cavernous hemangioma is one of the most frequently encountered benign hepatic neoplasms, hepatic sclerosed hemangioma is very rare. We report a case of hepatic sclerosed hemangioma that was difficult to distinguish from an intrahepatic cholangiocarcinoma by imaging studies.


METHODS
A 76-year-old male patient with right hypochondralgia was referred to our hospital. Abdominal ultrasonography revealed a heterogeneously hyperechoic tumor that was 59 mm in diameter in segment 7 of the liver. Dynamic computed tomography showed a low-density tumor with delayed ring enhancement. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) demonstrated a low-signal intensity mass with ring enhancement on T1-weighted images. The mass had several high-signal intensity lesions on T2-weighted images. EOB-MRI revealed a hypointense nodule on the hepatobiliary phase. From these imaging studies, the tumor was diagnosed as intrahepatic cholangiocarcinoma, and we performed laparoscopy-assisted posterior sectionectomy of the liver with lymph node dissection in the hepatoduodenal ligament. Histopathological examination revealed a hepatic sclerosed hemangioma with hyalinized tissue and collagen fibers.


CONCLUSIONS
Hepatic sclerosed hemangioma is difficult to diagnose preoperatively because of its various imaging findings. We report a case of hepatic sclerosed hemangioma and review the literatures, especially those concerning imaging findings.
Department of Surgery, JA Hiroshima General Hospital, 1-3-3, Jigozen, 738-8503,, Hatsukaichi, Japan.
Shunsuke
S
Miyamoto
Department of Surgery, JA Hiroshima General Hospital, 1-3-3, Jigozen, 738-8503,, Hatsukaichi, Japan. oshita-akihiko@umin.ac.jp.|Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan. oshita-akihiko@umin.ac.jp.
Akihiko
A
Oshita
Department of Pathology, JA Hiroshima General Hospital, Hatsukaichi, Japan.
Yutaka
Y
Daimaru
Department of Surgery, JA Hiroshima General Hospital, 1-3-3, Jigozen, 738-8503,, Hatsukaichi, Japan.
Masaru
M
Sasaki
Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Hideki
H
Ohdan
Department of Surgery, JA Hiroshima General Hospital, 1-3-3, Jigozen, 738-8503,, Hatsukaichi, Japan.
Atsushi
A
Nakamitsu
D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis; D018281:Cholangiocarcinoma / Q000175:diagnosis; D003287:Contrast Media; D003937:Diagnosis, Differential; D019786:Gadolinium DTPA; D006391:Hemangioma / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D012598:Sclerosis; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA