Surgical treatment of cavernous hemangioma of the liver

Cavernous hemangioma of the liver was surgically treated in six men and two women, mean age 58 (51-63) years during a 37-year period. The size of hemangioma averaged 10 (5-15) cm. It was single in all cases and situated in the right liver lobe in seven. The indications for operation were suspected abdominal tumor or hepatic metastases in five cases, enlargement of previously known hemangioma in two, and spontaneous rupture of cavernous hemangioma with massive intra-abdominal bleeding in one case (emergency laparotomy). The operations comprised two right lobectomies, one left lobectomy, three atypical resections of the right liver lobe and two sublobar resections. The course after the elective operations was uneventful, but the patient with ruptured hemangioma died intraoperatively due to myocardial fibrillation after performance of right lobectomy. Although elective surgical treatment of cavernous hemangioma of the liver is safe, the natural history in most cases probably is benign and indications for surgery should be restrictive.