Rapidly Progressive Multiple Hepatic Hemangiomas Mimicking Angiosarcoma: A Case Report With Surgical and...

Area of Science:

• Hepatology
• Oncology
• Surgical Pathology

Background:

• Hepatic hemangiomas are common benign liver tumors, usually with slow growth.
• Rapidly enlarging hemangiomas are rare and pose diagnostic challenges, potentially mimicking hepatic angiosarcoma.
• Distinguishing aggressive hemangiomas from malignancy is critical for appropriate patient management.

Purpose of the Study:

• To report an extremely rare case of multiple hepatic hemangiomas with rapid progression.
• To discuss the diagnostic difficulties in differentiating these lesions from hepatic angiosarcoma.
• To evaluate the efficacy of surgical intervention and transarterial chemoembolization (TACE) in managing such cases.

Main Methods:

• Case presentation of a 39-year-old woman with multiple, rapidly growing hepatic hemangiomas.
• Diagnostic workup including imaging and surgical resection (hepatectomy).
• Therapeutic intervention with transarterial chemoembolization (TACE) using epirubicin for residual tumor control.

Main Results:

• Initial laparoscopic hepatectomy revealed cavernous hemangioma with intravascular papillary endothelial hyperplasia (IPEH).
• Subsequent rapid regrowth and new lesion development necessitated repeat hepatectomies.
• Transarterial chemoembolization (TACE) achieved stable disease for 16 months in residual lesions.

Conclusions:

• Multiple hepatic hemangiomas can exhibit exceptionally rapid progression, mimicking hepatic angiosarcoma.
• Repeated hepatectomy may be required for diagnosis and treatment of rapidly progressing hemangiomas.
• Transarterial chemoembolization (TACE) is an effective modality for stabilizing residual or recurrent hepatic hemangiomas.