An estimated 1–5 percent of adults in the United States have small liver hemangiomas that cause no symptoms and do not need treatment. Larger hemangiomas can cause pain or discomfort.
In this article, we discuss the symptoms, causes, and treatment of a hemangioma in the liver, in addition to diagnosis and possible complications.
What is a hemangioma of the liver?
A liver hemangioma is a non-cancerous lump made of blood vessels.
When a collection of blood vessels forms a lump, it is called a hemangioma. Some hemangiomas occur externally on the skin while others develop inside the body, including on organs such as the liver.
Hemangiomas are usually less than 5 centimeters (cm) across. Although some people may have multiple hemangiomas, it is more common only to have one.
Hemangiomas are not malignant, meaning that they do not become cancerous.
A hemangioma of the liver is also called a hepatic hemangioma or a cavernous hemangioma.
Hemangiomas of the liver very rarely cause symptoms, as people usually have small-sized and solitary liver hemangiomas.
However, more rarely, people can have multiple hemangiomas in their liver. They may also have larger hemangiomas.
If a hemangioma is larger than 4 cm in diameter, it may cause the following symptoms:
- abdominal discomfort and bloating
- loss of appetite
- a sense of fullness after eating a small meal
In severe cases, a larger hemangioma can rupture. This can interfere with organ function and cause bleeding into the abdomen or widespread blood clotting. It can lead to heart failure and can be fatal.
What causes a liver hemangioma?
Doctors are still not sure what causes liver hemangiomas.
In some cases, liver hemangiomas may be present from birth, but they can also develop at any point during a person's life. They are more common in people aged 30–50 years, and more likely to occur in women than in men.
An MRI scan can identify a hemangioma.
If a hemangioma is large enough to cause symptoms, a doctor may order imaging tests to look for abnormalities in the liver. These tests may include:
In most cases, people do not know that they have a liver hemangioma until a doctor detects it when testing for another condition.
Hemangiomas often do not need treatment, and there is no evidence that people with untreated liver hemangiomas will develop liver cancer.
However, depending on their location, size, and number, some hemangiomas may be problematic. It is often best to treat a hemangioma if it is large and causing symptoms.
Possible treatments for people with liver hemangiomas include:
- Medication such as corticosteroids.
- Blocking the hemangioma's blood supply. Doctors can perform a procedure to cut off the blood supply to the hemangioma to stop it from growing. This procedure is called selective hepatic artery embolization or hepatic artery ligation.
- Surgery to remove the hemangioma. A doctor can remove a hemangioma when it is possible to separate it from the liver, although they may sometimes need to remove part of the liver too.
- Liver transplant. Doctors rarely perform this procedure, except in the case of large or multiple hemangiomas that it is not possible to treat in other ways.
Some birth control pills may cause liver hemangiomas to grow.
Most liver hemangiomas do not cause complications.
However, people who are pregnant or taking medicines containing the female hormone estrogen, including some birth control pills, are more likely to experience complications from liver hemangiomas. This might be because estrogen can cause liver hemangiomas to enlarge.
During pregnancy, there is an increase in estrogen. Women with a liver hemangioma can still become pregnant, but they should discuss their plans with a doctor.
Although many people refer to them as tumors, hemangiomas are not malignant and do not become cancerous. There is no evidence to suggest that people who do not treat a liver hemangioma can develop liver cancer.
Most people with liver hemangiomas have no symptoms and do not require medical treatment.
Liver hemangiomas rarely cause complications, although larger or multiple hemangiomas can cause painful or uncomfortable symptoms.
If someone suspects that they have a liver hemangioma, they should speak to a doctor about the best ways to diagnose and manage the condition.