title: Prevalence and clinical outcome of hepatic haemangioma with specific reference to the risk of rupture: A large retrospective cross-sectional study.
abstract: BACKGROUND
  Prevalence and incidence of hepatic haemangioma are estimated from autopsy series only. Although benign and generally asymptomatic, hepatic haemangioma can cause serious complications.
  
  
  OBJECTIVE
  The aim of the study was to assess the prevalence of hepatic haemangioma and to attempt to quantify the risk of major complications such as spontaneous rupture.
  
  
  METHODS
  We retrospectively analyzed the radiology database of a Regional University Hospital over a 7-year period: the radiological records of 83,181 patients who had an abdominal computed tomography or magnetic resonance scan were reviewed. Diagnoses made at imaging were reviewed and related to clinical course.
  
  
  RESULTS
  Hepatic haemangioma was diagnosed in 2071 patients (2.5% prevalence). In 226 patients (10.9%), haemangioma had diameter of 4 cm or more (giant haemangioma). The risk of bleeding was assessed on patients without concomitant malignancies. Spontaneous bleeding occurred in 5/1067 patients (0.47%). All 5 patients had giant haemangioma: 4 had exophytic lesions and presented with haemoperitoneum; 1 with centrally located tumour experienced intrahepatic bleeding.
  
  
  CONCLUSIONS
  Giant haemangiomas have a low but relevant risk of rupture (3.2% in this series), particularly when peripherally located and exophytic. Surgery might be considered in these cases.
authors.affiliation: Hepatobiliary and Transplantation Surgery, Department of Clinical and Experimental Medicine, Polytechnic University of Marche, Italy. Electronic address: federicomocchegiani@hotmail.com.
authors.forename: Federico
authors.initials: F
authors.lastname: Mocchegiani
authors.affiliation: Hepatobiliary and Transplantation Surgery, Department of Clinical and Experimental Medicine, Polytechnic University of Marche, Italy. Electronic address: pvincenzi@fastwebnet.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Vincenzi
authors.affiliation: Hepatobiliary and Transplantation Surgery, Department of Clinical and Experimental Medicine, Polytechnic University of Marche, Italy. Electronic address: martina.coletta@libero.it.
authors.forename: Martina
authors.initials: M
authors.lastname: Coletta
authors.affiliation: Radiology, Department of Specialistic Clinical and Odontostomatological Sciences, Polytechnic University of Marche, Italy. Electronic address: andrea.agostini84@yahoo.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Agostini
authors.affiliation: Clinic of Gastroenterology, Department of Clinic and Molecular Sciences, Polytechnic University of Marche, Italy. Electronic address: m.marzioni@univpm.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Marzioni
authors.affiliation: Clinic of Gastroenterology, Department of Clinic and Molecular Sciences, Polytechnic University of Marche, Italy. Electronic address: g.svegliati@univpm.it.
authors.forename: Gianluca Svegliati
authors.initials: GS
authors.lastname: Baroni
authors.affiliation: Radiology, Department of Specialistic Clinical and Odontostomatological Sciences, Polytechnic University of Marche, Italy. Electronic address: a.giovagnoni@univpm.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Giovagnoni
authors.affiliation: Clinic of Surgery, Department of Clinical and Experimental Medicine, Polytechnic University of Marche, Italy. Electronic address: m.guerrieri@univpm.it.
authors.forename: Mario
authors.initials: M
authors.lastname: Guerrieri
authors.affiliation: Clinic of Surgical Training, Department of Clinical and Experimental Medicine, Polytechnic University of Marche, Italy. Electronic address: c.marmorale@univpm.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Marmorale
authors.affiliation: Clinic of Surgery, Department of Medical and Biological Sciences, University of Udine, Italy. Electronic address: a.risaliti@uniud.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Risaliti
authors.affiliation: Hepatobiliary and Transplantation Surgery, Department of Clinical and Experimental Medicine, Polytechnic University of Marche, Italy. Electronic address: vivarelli63@libero.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Vivarelli
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D033162:Incidental Findings; D007558:Italy / Q000453:epidemiology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000453:epidemiology; D014057:Tomography, X-Ray Computed
keywords: Hepatic haemangioma; Risk of rupture; Treatment