Twelve patients with
cavernous hemangiomas of the liver were treated by surgical resection from 1982 to 1991. There were three male and nine female patients. Their ages ranged from 31 to 62 with a mean of 49. All except one with gall bladder
polyp had
abdominal pain. Preoperatively, dynamic computerized tomographic scans performed on three patients produced accurate diagnoses, while angiography was correct in only 2 out of 7 patients. The indications for operation were suspected
hepatoma in five, symptomatic
pain in three, intraperitoneal
hemorrhage resulting from biopsy in one, intrahepatic stone with suspicion of
cholangioma in one, abdominal mass mimicking a gastric
leiomyosarcoma in one and incidental
laparotomy in a final patient. Surgical treatment resulted in no operative mortalities apart from one delayed death from cirrhotic decompensation occurring four months postoperatively. Morbidity included one patient with a
postoperative hemorrhage and one with bile leakage, however, both of them were discharged uneventfully. During the follow up period from 6 to 72 months, no more
abdominal pain attacked in those three patients with preoperative symptomatic
pain. Three patients developed multiple recurrent
hemangiomas. No identifiable causes were readily apparent. We conclude that the preoperative differentiation between
hemangioma and
hepatoma in a hepatic lesion is very important. When necessary, such as a giant symptomatic
hemangioma of the liver can be safely resected without significant complications.