Hemangiomas

  My wife has a relatively large (4.7 cm) hemangioma with a second smaller one also.  At this point she is asymptomatic.  It seems to have grown over the last few years being 3 cm or so  years ago.  Other than monitoring, is there anything that needs to be done?  If it grows further, what options are there?
  Thanks,
Dear Joe,
Hemangiomas are the most common benign tumor of the liver. They occur at all ages but are most common in the third, fourth and fifth decades of life. They are more common in women. They may increase in size during pregnancy. Most are seen incidentally on various imaging studies. Although a hemangioma has a characteristic echogenic appearance on ultrasound, this appearance is not peculiar to hemangioma. When a hemangioma is detected on ultrasound it is often confirmed with a second study called dynamic hepatic blood flow scintigraphy (red blood cell scan). This scan can detect hemangiomas 3 cm or larger with good accuracy. Other more expensive tests such as a dynamic CT scan or MRI are more accurate and can even detect smaller hemangiomas. Surgical treatment for hemangioma is only indicated if it is large, increasing in size and displacing surrounding structures and organs, causing severe symptoms, or thrombosis or hemorrhage of the tumor is present (acute abdominal pain). I do not believe that hemangiomas disappear, but once confirmed with a second imaging modality, they do not need to be so closely followed unless symptoms are present.
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