Sonographically detected hepatic hemangiomas: absence of change over time

Hepatic hemangiomas are the most common benign tumors of the liver and commonly present as incidental findings on sonographic examination of the abdomen. To chart more precisely the natural course of the sonographic appearance of hepatic hemangiomas, 47 patients with 68 hemangiomas were rescanned 1-6 years after the initial study. Fifty-six lesions (82%) showed an identical appearance on follow-up study. However, 12 (18%) of the lesions had an appreciably changed sonographic appearance. Three lesions could not be found, seven were less obvious (less echogenic), one was larger, and one smaller. This study shows that once hemangiomas are identifiable sonographically in adults, they have reached a stable size and change in size or appearance only rarely. They do not continue to grow slowly over time. Furthermore, this study also confirms that the sonographic appearance in the appropriate patient can differentiate these hemangiomas relatively reliably from metastases.