CT of giant cavernous hemangioma

Area of Science:

• Radiology
• Hepatology
• Oncology

Background:

• Giant hepatic cavernous hemangiomas (>8 cm) differ clinically from smaller lesions.
• These large tumors can mimic primary or metastatic liver malignancies on imaging.
• Clinical presentation may include right upper quadrant discomfort or hepatomegaly.

Purpose of the Study:

• To characterize the computed tomography (CT) findings of giant hepatic cavernous hemangiomas.
• To differentiate these benign lesions from malignant liver tumors using CT features.
• To establish imaging criteria for confident diagnosis and avoidance of invasive procedures.

Main Methods:

• Retrospective analysis of eight women with giant hepatic cavernous hemangiomas (mean diameter 13.7 cm).
• Review of unenhanced and contrast-enhanced computed tomography (CT) scans.
• Evaluation of lesion density, internal characteristics, and enhancement patterns post-contrast.

Main Results:

• On unenhanced CT, most masses were hypoattenuating compared to liver parenchyma.
• Characteristic findings included stellate or cleft-like low-density zones.
• Contrast administration revealed early peripheral enhancement with partial centripetal fill-in, not becoming fully isodense on delayed scans.

Conclusions:

• Specific CT imaging features of giant hepatic cavernous hemangiomas can be identified.
• A high index of suspicion combined with familiarity of these CT characteristics aids diagnosis.
• Accurate CT diagnosis can prevent the need for potentially risky needle biopsies.