[Liver hemangiomas - when is invasive treatment indicated?]

Area of Science:

• Hepatology
• Surgical Oncology
• Interventional Radiology

Background:

• Liver hemangiomas are common benign liver tumors, often asymptomatic and incidentally discovered.
• While typically managed conservatively, symptomatic or giant hemangiomas may necessitate intervention.
• Treatment decisions for liver hemangiomas require careful consideration of patient factors and lesion characteristics.

Purpose of the Study:

• To define optimal treatment strategies for liver hemangiomas based on clinical experience and literature review.
• To establish criteria for selecting appropriate interventions for symptomatic or giant liver hemangiomas.
• To guide clinical decision-making in the management of liver hemangioma patients.

Main Methods:

• Retrospective analysis of 37 patients with giant liver hemangiomas undergoing invasive treatment over five years.
• Surgical interventions included enucleation, non-anatomical resection, and lobectomy.
• Percutaneous transarterial embolization (TAE) was performed in a significant portion of patients.

Main Results:

• Zero mortality reported in the study cohort.
• Post-surgical complications included transient hematoma in the resection line.
• Post-embolization syndrome occurred in some patients; TAE showed variable long-term outcomes regarding hemangioma progression or stability.

Conclusions:

• Conservative management is suitable for most asymptomatic liver hemangiomas.
• Surgical intervention, preferably enucleation or non-anatomical resection, is indicated for giant symptomatic or growing lesions (>10 cm).
• Transarterial embolization (TAE) is a viable option for high-risk patients and can be repeated if necessary.