With the increasing awareness of health care and the improvement of diagnostic imaging technology, a large number of asymptomatic hepatic hemangiomas have been discovered. Some patients are extremely nervous about whether the hemangioma will turn into the king of cancers, liver cancer. So, does hepatic hemangioma need surgery or drug treatment? In fact, patients should not worry too much. Hepatic hemangioma is a benign disease Hepatic hemangioma is a common benign disease, and it has been reported that the incidence of hepatic hemangioma in normal population is 0.5% to 7%. Although the etiology is not clear, all exhibit abnormal development of hepatic blood vessels. Hepatic hemangiomas are mostly purplish-red or bluish-purple in color, with smooth surface and soft texture. If blood is squeezed out of the tumor, the tumor can be significantly reduced. The size of hepatic hemangioma may vary from person to person, ranging from less than 1 cm in small cases to tens of cm in large cases. In the past, the medical community mostly thought that hepatic hemangiomas were congenital, but with the development of imaging examinations, it was found that many patients grew after middle and old age. In addition, there are more women than men, with a male-to-female ratio of about 1:5. Combined with basic research, it is thought that the occurrence of hepatic hemangiomas may be related to female hormones. But the question is – do all hepatic hemangiomas require treatment? Usually, hepatic hemangiomas can be divided into two types: growing and non-growing types. A hepatic hemangioma that increases in size over time is called a growth type; the opposite is called a non-growing type. It can also be defined as 5 cm, below 5 cm is usually non-growing type and above 5 cm is non-growing type. The good thing is that 95% of clinical hemangiomas are non-growing type, they generally do not grow, do not become malignant, and do not rupture, therefore, most liver hemangioma “patients” do not need surgery and medication, and do not need to pay attention to anything. However, if the tumor is more than 5 cm in diameter and tends to continue to grow, surgery should be considered because large hemangiomas can produce compression symptoms and pose a risk of rupture and potential bleeding. Some experts also believe that surgery should be considered when the tumor exceeds 10 cm. However, waiting until the tumor grows up will not only make the patient bear a huge psychological burden all the time, but also may increase the difficulty of surgery and even lose the chance of surgery, so it is not necessary to wait until the diameter is 10 cm. In addition, many medical institutions are now carrying out interventional techniques to treat hepatic hemangioma, and good results have been reported. Although interventional techniques are minimally invasive, they may cause serious complications such as liver necrosis, bile duct occlusion, and jaundice. Huang Zhiqiang, a famous hepatobiliary surgeon in China, has repeatedly called for a ban on the indiscriminate use of interventional therapy in the treatment of hepatic hemangioma. Therefore, generally speaking, if hepatic hemangioma is treated, surgical methods are preferable. However, experience tells us that sometimes the diagnosis of hepatic hemangioma is not so easy, especially individual hepatocellular carcinoma is easily misdiagnosed as hepatic hemangioma, which delays the disease. Therefore, it is important – hepatic hemangioma must be prevented from misdiagnosis Generally speaking, it can be diagnosed by ultrasound, color ultrasound, and CT scan. However, in order to prevent misdiagnosis, the following points should also be noted: 1. In addition to the imaging examinations mentioned above, serum fetoprotein and hepatitis B index (commonly known as hepatitis B two-to-one half) should be checked for liver occupying lesions, and if there is any abnormality, the possibility of liver cancer should be highly suspected; 2. Try to have more than two kinds of imaging examinations at the same time to corroborate each other and reduce the misdiagnosis rate; 3. Regular follow-up examinations should be conducted at least twice a year. Once the change of the disease is detected, it can be dealt with in time; 4. Go to professional medical institutions for examination and diagnosis. The largest hepatic hemangioma removed in China is 63cm x 48.5cm x 40cm, and the general surgery department of 88 Hospital has successfully removed a hepatic hemangioma of over 30cm. Those who cannot be resected may be considered for resection; those who cannot be resected may be subjected to tumor ligation.