“Hello doctor, please look at the film, the doctor at home said that I have a hemangioma on my liver, the location is not very good, can not do the operation, otherwise it will help me to open the knife, do you think it can be done in your place?” This is a situation often encountered in the outpatient clinic. Today we will talk about hepatic hemangioma. Liver hemangioma, one of the most common benign tumors of the liver! With the improvement of social standard of living, people’s concern for health has reached an unprecedented height, is not there a saying: there is nothing can not have a disease! Thanks to the popularity of health checkups, the detection rate of hepatic hemangiomas has become higher and higher, and the number of people coming for consultation has also shown a significant upward trend. How to detect hemangioma? Upper abdominal ultrasonography is the most commonly used imaging technique for health checkups. Liver hemangiomas show up on ultrasound as hypoechoic, with an internal sieve-like mesh. Ultrasound is more subjective and is also described as a liver occupancy, hypoechoic, mass of undetermined nature, etc. The findings are then followed by a statement at the end of the test that a hepatic hemangioma is possible and that CT or MRI is recommended for further investigation. Many people get the report and freak out, anyone who is afraid of getting sick and still on the liver. How to make a clear diagnosis? Although hemangiomas are the most common benign tumors, it’s not just an ultrasound report that will do the trick; a definitive diagnosis must be made in order to have peace of mind. From the imaging point of view, if your physical examination report suggests the possibility of liver hemangioma, don’t worry, go to the nearest hospital (preferably with Hepatobiliary Surgery, at least with General Surgery) in an appointment for a liver-enhancing Magnetic Resonance Imaging (MRI) examination. Because hemangioma is easier to diagnose on MRI. Clearly is a hemangioma, then it will be relieved, if not, then we should bring the film to see a specialist. In my clinical work, I have seen such a patient: a young woman in her 20s, who was found to have multiple hemangiomas of the liver in a foreign hospital 2 years before she came to my clinic. The doctor recommended follow-up and observation, but she kept ultrasound review because the tumor was getting bigger and the lesions were increasing, and then she came to our hospital accompanied by her father. At that time, after reading her previous ultrasound reports, she was still advised to have an MRI examination and then look at it again. When the MRI was done, it was found that there was a misdiagnosis of multiple tumors in the liver, but they were not hemangiomas, nor were they highly malignant tumors, or else they would not have been able to be followed up safely for 2 years. The patient was hospitalized and operated, and the postoperative pathology diagnosed endocrine tumor of the liver. It has been 5 years since the surgery, and the follow-up is very good, and the child can even play soy sauce. I am very happy! As the saying goes, “every foot has its own shortcomings and every inch has its own longcomings”, my advice is that whenever you suspect a hemangioma, you must confirm the diagnosis with at least two imaging tests in order to have peace of mind. Treatment of Hemangioma? Does that mean you have to operate on a hemangioma as soon as it is found? The answer is no. As mentioned earlier, hemangiomas are benign, are more common in females, do not spontaneously rupture, and do not undergo malignant changes. I remember when I first joined the work, under the leadership of the superior doctor, clinical consultation of liver hemangioma, regardless of the size, basically take surgical treatment, with the deeper and deeper understanding of this disease, and now see patients with hemangiomas, almost all recommend regular review with can. Then you may ask, how the benign ones still need surgery? There are always exceptions, some people still need surgery, there are two reasons. First, psychological factors, some patients with poor psychological tolerance, once they know that their liver has a tumor, can not eat or sleep. They may have repeatedly visited many hospitals, looking for specialists and familiar doctors, just to know the best treatment plan, even if one of them says that surgery is possible, then it must be the best. From a biopsychological point of view, surgery to remove the tumor is ultimately chosen. There is also a situation where the tumor has grown so large that it has seriously affected the patient’s life and work. For those of you who are concerned about Shanghai Eastern Hepatobiliary Surgery Hospital, you may know that our beloved academician Wu Mengchao once performed a case of resection of a hemangioma, which may be the largest hemangioma reported in the world. The patient was a farmer from Anhui Province, and the tumor occupied the abdominal cavity, seriously affecting the normal life of the patient. The postoperative recovery was also excellent. In summary, if you find a hemangioma on ultrasound during a physical exam, don’t be nervous and visit a hepatobiliary specialist. In most cases, just follow up and observe regularly. If you want to know more, you are also welcome to add my personal online workstation to answer your questions. The epidemic in Shanghai has come to a special time again. Today, Pudong and Puxi are starting to be treated separately, so I hope the epidemic will be over sooner rather than later, and everyone will return to their normal studies and lives. I wish all readers all the best.