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Spontaneous regression of liver hemangiomas: a single-institution analysis of 46 patients
Oğuzhan Aydin1, Bülent Acunaş2, Arzu Poyanli2
1Departments of General Surgery (Hepatopancreatobiliary Surgery Unit).
Insights
Spontaneous regression of liver hemangiomas is an underrecognized phenomenon, occurring in 6.4% of patients. Some hemangiomas may enlarge before regressing, and regressed lesions can mimic malignancy.
Area of Science:
- Hepatology
- Radiology
- Oncology
Background:
- Liver hemangiomas are common benign tumors.
- Spontaneous regression is not widely recognized.
Purpose of the Study:
- To investigate the characteristics of spontaneous regression in liver hemangiomas.
- To determine the incidence and patterns of regression.
Main Methods:
- Retrospective analysis of 716 adult patients with liver hemangiomas.
- Follow-up for at least 3 years using cross-sectional imaging.
Main Results:
- Spontaneous regression observed in 6.4% of patients (46/716).
- 69 of 87 regressed lesions showed regression; 11 enlarged before regression.
- 14% of regressed lesions developed atypical features mimicking malignancy.
Conclusions:
- Spontaneous regression of liver hemangiomas is an underrecognized event.
- Enlargement does not always necessitate intervention due to potential subsequent regression.
- Regressed hemangiomas require consideration in the differential diagnosis of suspicious liver lesions.
Objective:
The aim of this study was to determine the nature of spontaneous regression of liver hemangiomas.
Patients And Methods:
The records of the liver hemangioma patients who attended the out-patient clinic between 1988 and 2018 were evaluated. The data of the 716 adult patients who were followed for at least 3 years with cross-sectional imaging were analyzed.
Results:
Spontaneous regression was documented in 46 patients (6.4%). Twenty-eight patients had a single hemangioma (61%), eight (17%) had two hemangiomas; the other 10 patients had 3-6 hemangiomas. Of the 87 lesions in 46 patients, 69 actually regressed during the study. Twelve patients with more than one lesion exhibited discordant courses - one of the hemangiomas of a patient with multiple lesions regressed, whereas the other enlarged or remained stable. Eleven of the regressed hemangiomas exhibited enlargement first, followed by spontaneous regression. Fourteen (20%) of the regressed hemangiomas acquired atypical characteristics that would have suggested a malignancy had the original films been unavailable.
Conclusion:
Spontaneous regression of liver hemangiomas is an underrecognized phenomenon. Enlargement should not be a straightforward indication for intervention because it may be followed by regression. A regressed hemangioma should be considered in the differential diagnosis of liver lesions suspicious for malignancy.
