liver hemangioma

  : : I have just been diagnosed with 5, located on both lobes; one is large (8 cm,) the others small.  (I have struggled with reflux for two + years.  Recently the pain changed.....to upper back, mostly right.  The reflux drugs do not work for me.)
  : : Is there a connection between the reflux and this liver growth?
  : : I will have a repeat scan in about 6 weeks.  I will see a surgeon to establish that contact, just in case.  I am told that the primary concerns are for growth and/or bleeding.
  : : What are the chances that this will grow?  And why is that a concern?  Is growth ever very rapid?
  : : What symptoms would signal a bleed?
  : : How much time would I have to seek care?
  : : Would bleeding automatically indicate that surgery is necessary?
  : : Is there anything conservative that I can do?  (I have been advised to try to go off premarin, and I will.)
  : : Any other advice would be most welcome!
  :
  : Dear Susan,
  : 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. This supports the view that hormonal influences may influence growth of hemangiomas. 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). Since your hemangioma is large it may cause compression of the stomach leading to reflux. Most hemangiomas are slow growing and if bleeding is present, surgery is usually recommended immediately.
  : This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
  : If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
  : HFHSM.D.-ym
  : *Keywords: liver hemangioma
  
  Hello again.......and thank you so much for your fast and helpful response to my first questions.  With a little more time to ponder and some research I have a few more:
  What would cause a rupture of my large (8cm) hemangioma?
  What would constitute "severe symptoms?"
  How much time would I have to get help from the onset of severe symptoms?
  Is there a possibility for these to recede?  (I have stopped taking estrogen.)
  Is there any necessity to limit activity?  (I am 52.......swim and do cybex circuit training.......drive extensively for my job, which is otherwise sedentary.  Love to travel to places like Mexico etc.)
  Is there anything else that I can do to improve my situation?
  Thank you again !!!!
Dear Susan,
I will answer your questions in order.
1. Hemangiomas usually do not grow, but if they do they are most often slow growing. If they become very large they can cause symptoms because of compression of surrounding structures.
2. Acute onset of abdominal pain can signal a bleed.
3. In the case of an acute blood and the onset of severe abdominal pain you would have to get to an emergency room fairly quickly.
4. Most surgeons will operate when bleeding has occurred.
5. I believe you are doing all you can at this point. A repeat scan will indicate whether there has been interval growth and if there is compression. Continued growth would also be an indication for surgery.
I hope you find this information helpful.

This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call  1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
HFHSM.D.-ym
*Keywords: liver hemangioma

[kimberleycutie]

A related discussion, Liver Hemangiomas was started.