Hepatic hemangioma is a common benign tumor of the liver, mainly divided into cavernous hemangioma, sclerosing hemangioma, hemangioendothelioma and capillary hemangioma. The most common type of hepatic hemangioma is cavernous hemangioma. In terms of size, number and location, they can be divided into small hepatic hemangioma and giant hepatic hemangioma; single hepatic hemangioma and multiple hepatic hemangioma; left lobe hemangioma and right lobe hemangioma. What we generally call hepatic hemangioma is cavernous hemangioma. It can occur at any age, mostly in 30~60 years old, and is more common in women than men. They can vary in size and can occupy the entire abdominal cavity in large cases. Most are smaller than 3 cm, but since the advent of ultrasonography, multiple hemangiomas have been observed. They can occur in both the left and right lobes of the liver, with the right lobe being the most common. The tumor may appear in any part of the liver, often under the envelope, and is mostly solitary (about 10% are multiple), with a diameter of less than 4 cm, but may be as small as a few mm, or as large as 30 cm. Sometimes thrombosis and scarring can be seen within the hemangioma, and occasionally calcification. Microscopically, hemangioma is a network of empty spaces lined with flattened endothelial cells of different sizes, containing red blood cells, and sometimes fresh mechanized thrombi. The tumor is clearly demarcated from the surrounding tissues. Clinical manifestations It is often found accidentally during physical examination for abdominal ultrasound, and can be observed regularly; about 40% of those above 4cm are accompanied with abdominal discomfort, hepatomegaly, loss of appetite, indigestion and other symptoms, which should be treated. Hepatic hemangioma often contains mechanized thrombus which may cause swelling of the tumor due to repeated thrombosis, causing Glisson′s envelope pulling and swelling. The masses vary in softness and firmness, with varying degrees of compressibility, and a few are firm and nodular. The masses rarely rupture spontaneously. Liver function is generally normal. The rare syndromes of large hemangiomas are depleted coagulation disorders, thrombocytopenia, and hypofibrinemia. A variety of imaging studies are available to aid in the diagnosis. Ultrasound images show a typical echogenic area with well-defined margins and visible ductal access. CT contrast enhancement or delayed scans show hyperenhancement around the tumor and gradual filling to the center in isointensity. The signal intensity of normal liver parenchyma was significantly attenuated and the tumor/liver signal intensity ratio was significantly increased. The nuclear blood pool scan showed significant filling. Needle biopsy is often contraindicated because it can lead to severe bleeding. So, how to determine whether the diagnosis of hepatic hemangioma is misdiagnosed or not is the most important concern of patients with hepatic hemangioma, and the following is my humble opinion. 1.The diagnosis must be confirmed by strengthening CT, if CT still confirms the diagnosis of hemangioma, then the following diagnosis can be made. 2. If the patient has cirrhosis, hepatitis B and AFP positive at the same time, then it is more likely to be hepatocellular carcinoma and must be closely watched. Most of the liver cancers grow rapidly and can grow exponentially or even several times within a month, even the very few slow growers can have more than 30% growth within a month, while liver hemangioma grows slowly and most of them do not grow in volume within a year. Therefore, after a patient is diagnosed with hepatic hemangioma, he should still be actively reviewed within one year, and the review can be arranged in this way (ultrasound can be used for the review) II. The most common is cavernous hemangioma. In terms of size, number and location, they can be divided into small hepatic hemangioma and giant hepatic hemangioma; single hepatic hemangioma and multiple hepatic hemangioma; left lobe hemangioma and right lobe hemangioma. What we generally call hepatic hemangioma is cavernous hemangioma. It can occur at any age, mostly in 30~60 years old, and is more common in women than men. They can vary in size and can occupy the entire abdominal cavity in large cases. Most are smaller than 3 cm, but since the advent of ultrasonography, multiple hemangiomas have been observed. They can occur in both the left and right lobes of the liver, with the right lobe being the most common. The tumor may appear in any part of the liver, often under the envelope, and is mostly solitary (about 10% are multiple), with a diameter of less than 4 cm, but may be as small as a few mm, or as large as 30 cm. Sometimes thrombosis and scarring can be seen within the hemangioma, and occasionally calcification. Microscopically, hemangioma is a network of empty spaces lined with flattened endothelial cells of different sizes, containing red blood cells, and sometimes fresh mechanized thrombi. The tumor is clearly demarcated from the surrounding tissue.