Painful hepatic hemangioma: report of a case with an emphasis on sonographic findings.
Hepatic hemangiomas are usually asymptomatic and very rarely produce abdominal symptoms. We report a painful 10 × 9 cm hemangioma situated at the hepatic surface of segment 6. The lesion showed a heterogeneous internal structure, composed irregularly of hyperechoic and hypoechoic areas, and it also showed weak posterior echo enhancement. Contrast-enhanced US showed the so-called fill-in pattern, leading to the diagnosis of hepatic hemangioma. The patient's abdomen showed no other abnormal findings, which stressed the relationship between the hemangioma and the patient's symptoms. When the diagnosis of hepatic hemangioma is conclusive, surgical therapy is indicated only in patients with severe symptoms. Our patient was considered to be a candidate for enucleation of the lesion. Histopathologically, the lesion included no areas of hemorrhage or necrosis, and the patient's abdominal pain was likely due to distension of the liver capsule. After surgery, the patient was completely free of symptoms, and enucleation was considered to be appropriate.
Department of Gastroenterology, Akita Red Cross Hospital, 222-1 Naeshirozawa, Saruta, Kamikitade, Akita, 010-1495, Japan. rkatou@hotmail.com.
Ryusuke
R
Kato
Department of Gastroenterology, Akita Red Cross Hospital, 222-1 Naeshirozawa, Saruta, Kamikitade, Akita, 010-1495, Japan.
Hideaki
H
Ishida
Department of Gastroenterology, Akita Red Cross Hospital, 222-1 Naeshirozawa, Saruta, Kamikitade, Akita, 010-1495, Japan.
Hitoshi
H
Yagisawa
Department of Gastroenterology, Akita Red Cross Hospital, 222-1 Naeshirozawa, Saruta, Kamikitade, Akita, 010-1495, Japan.
Toru
T
Ishii
Department of Gastroenterology, Akita Red Cross Hospital, 222-1 Naeshirozawa, Saruta, Kamikitade, Akita, 010-1495, Japan.
Tomoya
T
Komatsuda
Department of Radiology, Akita Red Cross Hospital, 222-1 Naeshirozawa, Saruta, Kamikitade, Akita, 010-1495, Japan.
Takaharu
T
Miyauchi
Department of General Surgery, Akita Red Cross Hospital, 222-1 Naeshirozawa, Saruta, Kamikitade, Akita, 010-1495, Japan.
Tsutomu
T
Sato
Department of Pathology, Akita Red Cross Hospital, 222-1 Naeshirozawa, Saruta, Kamikitade, Akita, 010-1495, Japan.
Ken
K
Saito
Abdominal pain; Contrast-enhanced sonography; Hepatic hemangioma; Liver tumor; Ultrasound