[1778] Giant and Small Cavernous Hemangiomas of the Liver: A Clinicopathologic Comparison Including Hemangioma-Like Vessels

Qing Zhao, Melissa Taggart, Susan C Abraham. MD Anderson Cancer Center, Houston

Background: Cavernous hemangioma (CH) is the most common benign liver tumor. A recent publication described several underrecognized features of CH, including the presence of hemangioma-like vessels (HLVs) in the liver parenchyma adjoining giant CHs (Liver Int. 2006;26:334-8). The authors of that study postulated that HLVs might be a mechanism of CH expansion, as they were very common (15 of 19, 79%) around giant CH. However, CHs of smaller sizes were not studied and it is unknown if HLVs also occur in small CH and whether differences in HLV density might correlate with size and multiplicity of hepatic CH.
Design: We studied 28 patients with giant CH (>4 cm) and 56 patients with small CH (≤4 cm). Age, gender, and multiplicity of hepatic CH were recorded for each patient. For each CH, we determined the presence, number, greatest size, and distance of HLVs from the CH-liver interface. Because of the varying numbers of histologic sections of CH-liver interface taken for each case, we also calculated an HLV 'density' by dividing the total number of HLVs by the number of sections containing CH-liver interface (e.g., a CH with 2 HLVs in a total of 2 sections had a density of 1).
Results: Patients with giant CH were significantly younger than those with small CH. They were more likely to have multiple hepatic CH, but this did not reach statistical significance. HLVs were significantly more frequent around giant CH, occurred in greater numbers, and could be identified at greater distances from the CH-liver interface. Even when normalized for number of available histologic sections, giant CH demonstrated a significantly greater HLV density.

Clinicopathologic Comparison of Giant and Small Cavernous Hemangiomas (CH)
 Giant CHSmall CHp
Age49 (28-79) yr55 (34-83) yr0.02
Sex (female)57%61%NS
Multiple CH54%38%NS
HLVs present81%32%<0.001
HLV density2.830.47<0.001
HLV size≤3 mm≤2.2 mm--
HLV number≤200≤25--
HLV distance from CH≤4 cm≤0.7 cm--
* 26 giant CH from 28 patients and 71 small CH from 56 patients

Conclusions: Our study demonstrates significant clinicopathologic differences between patients with giant and small CH, especially in the prevalence, density, and maximum extent of HLVs. These differences support a role for HLVs in the growth and eventual size of hepatic angiomas.
Category: Liver

Tuesday, March 20, 2012 1:00 PM

Poster Session IV # 239, Tuesday Afternoon


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