Hepatic hemangiomas are benign tumors of the liver. Hepatic cavernous hemangiomas are the most common. Spongiform hemangiomas are usually solitary and occur mostly in the right lobe of the liver; about 10% are multiple and may be distributed in one or both lobes of the liver. Hemangiomas present in the liver as dark red, bluish-purple cystic elevations. They are lobulated or nodular, soft, compressible, and mostly clearly demarcated from adjacent tissues. Patients usually have no conscious symptoms. The cause of hemangioma formation is unknown, but some believe it is due to abnormal development of intrahepatic vascular structures, while others believe it is related to estrogen levels. The disease is more common in middle-aged women, and the incidence is six times higher in women than in men. Because the disease has no obvious symptoms and only presents as an intrahepatic occupying lesion, clinical attention should be paid to differentiate it from hepatocellular carcinoma. (1) Spongiotic hemangioma: The section is honeycomb, filled with blood, and the microscopic examination shows cystic sinusoids of different sizes, filled with red blood cells, and sometimes thrombosis. (2) Sclerosing hemangioma with closed lumen and degenerative changes of fibrous septum; (3) Vascular endothelial cell tumor with active proliferation of vascular endothelial cells, prone to malignant transformation; (4) Hepatic capillary hemangioma with narrow lumen and fibrous septum. Clinical manifestations 1.Small hemangiomas are asymptomatic, while larger hemangiomas may have distension and pain in the liver. 2.Small hemangioma is asymptomatic, but in larger hemangioma, a mass can be palpated in the right upper abdomen and the liver is large. 3.Large liver, mass and compression symptoms appear due to the enlargement of tumor, which are mostly asymptomatic in early stage. Diagnosis is mainly based on ultrasound, cT, nuclear scan and hepatic arteriography to confirm the diagnosis. Smaller hemangiomas with no symptoms do not need to be treated and can be observed dynamically, while partial hepatectomy can be chosen for those with compression symptoms. Most hemangiomas are solitary and less than 4 cm in diameter. Hepatic hemangiomas are often found incidentally during ultrasound examination, and their size and shape and number are not certain, and they are often congenital in nature. If the hepatic hemangioma is stationary and does not develop, it is usually not life-threatening without any conscious symptoms. 40% of hepatic hemangiomas over 4 cm are associated with abdominal discomfort, hepatomegaly, lack of appetite and indigestion. There may be fibrous tissue and mechanized thrombus in hepatic hemangioma, which may cause swelling of tumor and distension of liver peritoneum due to repeated thrombosis. Treatment principle 1.Tumor diameter <5cm does not need active treatment, regular review and follow up. 2.For tumor diameter >5cm, active treatment can be considered. 3.For tumor diameter <5cm and accompanied with clinical symptoms, active treatment can be considered. Treatment methods 1.hepatic hemangioma resection or liver lobectomy; 2.various interventional treatments, such as physical ablation (representative: radiofrequency treatment), chemical ablation (representative: alcohol ablation); 3.radiation therapy; 4.other local treatment methods. Zheng reminded that hepatic hemangioma is a common benign tumor, and no malignant change has been found so far, and there is still no curative drug for hepatic hemangioma, so generally no drug treatment is needed. Therefore, if the hemangioma is <5cm, there is no need to seek medical advice from anywhere, and regular follow-up can be done.