[Symptomatic compression of the vena cava caused by a small liver hemangioma]

Occasioned by a recurrent urinary infection, ultrasonography was performed on a 41-year-old otherwise healthy woman. There were no abnormal renal findings, but a 4.5 x 4.5 cm space-occupying lesion with the echo-typical pattern of an haemangioma was found in the right lobe of the liver. Magnetic resonance imaging and dynamic computed tomography demonstrated compression of the vena cava by the tumour which was localized to the caudate lobe. The T2-weighed pictures suggested a cavernous haemangioma which extended from the vena cava at the diaphragm to the portal vein bifurcation. Obstruction to flow became evident 10 months later as oedema of the lower legs, giving the indication for surgical removal of the haemangioma. The benign tumour was enucleated under total vascular occlusion without significant blood loss pre- and post-operatively. The patient was discharged symptom-free on the 13th postoperative day.