OVERVIEW
Cirrhotic hemangioma is a type of hepatic hemangioma with marked fibrosis and more vitreous lesions and scar tissue visible. It is clinically rare and is usually considered to be the end stage of hepatic hemangioma development.
Etiology
Intratumoral thrombus occurs during the progression of hepatic hemangioma, and fibrous connective tissue grows in after the thrombus is mechanized, resulting in scarring or vitreous degeneration, leading to cirrhotic hemangioma.
Symptoms
Most of the disease has no obvious clinical symptoms, and a small number of larger tumors are mainly found by imaging, but the imaging manifestations are mostly atypical.
Examination
1. Imaging examination
Some cirrhotic hemangiomas have less scar tissue and vitreous degeneration, and the enhanced CT performance is similar to that of a typical hemangioma, which is “fast in and slow out”. Some cirrhotic hemangiomas contain more unevenly distributed scar tissue and vitreous degeneration, resulting in atypical imaging, and the lesions on CT scan are mostly low-density areas, with no obvious enhancement in arterial phase, and no enhancement in portal vein or mild enhancement at the edge.
2.Histopathologic examination
Tumor section may be yellow, with intra-tumoral hemorrhage and necrosis. Microscopically, the tumor tissue consists of dilated capillaries, thick-walled arterioles, hyperplastic bile ducts, and a large area of collagenous connective tissue, and the walls of capillaries are thickened.
3. Liver puncture biopsy
Fibrosis is obvious. Since the imaging manifestations of cirrhotic hemangioma are similar to those of some liver malignant tumors, percutaneous hepatic puncture biopsy is recommended as a safe diagnostic technique before surgery. Timely hepatic puncture biopsy is useful in establishing the diagnosis and avoiding unnecessary surgery.
Diagnosis
The imaging manifestations of this disease are mostly atypical, and histopathologic examination is the gold standard for confirming the diagnosis of this disease.
Treatment
Surgical treatment is usually not required, and most patients undergo surgical resection, mainly because hepatic malignancy cannot be excluded.
Prognosis
The disease is a benign tumor with a good prognosis and rare rupture.