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.
|Giant CH||Small CH||p|
|Age||49 (28-79) yr||55 (34-83) yr||0.02|
|HLV size||≤3 mm||≤2.2 mm||--|
|HLV distance from CH||≤4 cm||≤0.7 cm||--|