Recently, many patients have consulted me and asked some questions about hepatic hemangioma. I would like to talk about the treatment knowledge of hepatic hemangioma based on my clinical experience for the reference of my colleagues and patients. Hepatic hemangioma is the most common benign tumor of the liver, mostly occurring in middle-aged women, mostly in the age of 30-50. The ratio of male to female is about 1:5~6. Histologically, intrahepatic hemangioma is a vascular malformation and can be classified as sclerosing hemangioma, hemangioendothelioma, capillary hemangioma and cavernous hemangioma according to the amount of fibrous tissue it contains. Clinically, cavernous hemangioma is the most common and is commonly known as hepatic hemangioma. The tumors vary in size and are mostly solitary or multiple, but are most common in the right liver. The smallest can be diagnosed only under microscope, while the larger ones can be up to 10 kg. The disease develops slowly and can last for several years to ten years. The exact etiology of hepatic hemangioma is still unclear, but congenital developmental abnormalities (embryonic vascular misshapen buds in the liver) are the most accepted. In addition, some scholars believe that the capillaries in the liver are deformed after infection, causing the capillaries to dilate into vacuoles, and the surrounding blood vessels are congested and dilated, resulting in regional blood circulation stagnation and sponge-like dilatation. Even recently, it has been found that hepatic hemangiomas are of hepatic arterial system origin. Some scholars have observed that the growth rate of hemangioma can be accelerated during female puberty, pregnancy and oral contraceptives, etc. It is believed that female hormones may also be one of the pathogenic mechanisms of hemangioma. Clinical symptoms When the tumor is small, it may be asymptomatic, but it is usually found during physical examination or dissection for other diseases. When the tumor is larger than 4cm in diameter, a few patients may have non-specific abdominal symptoms, mainly manifested as hepatomegaly or compression of adjacent organs such as gastrointestinal tumor, which may cause upper abdominal discomfort, abdominal distension, abdominal pain, loss of appetite, nausea, and acute abdominal symptoms. Spontaneous rupture bleeding is rare even in large hemangiomas. The Kasabach-Merritt syndrome, characterized by wasting coagulopathy, is occasionally seen in giant hemangiomas of varying degrees. There are also rare cases of biliary hemorrhage. The diagnosis can be confirmed by ultrasound, or by ultrasound combined with CT or MRI, taking into account the patient’s history of liver disease, serological examination and clinical manifestations. Specific image analysis will not be explained in detail here. The treatment of hepatic hemangioma depends on the size, location, growth rate, presence or absence of clinical symptoms and the accuracy of diagnosis. Small asymptomatic hepatic hemangioma does not need treatment, but ultrasound examination should be done every 3-6 months. Dynamic observation of mass changes. Combined with our clinical experience, we summarize the following points based on the principles of patient benefit, safety and effectiveness: (1) Masses larger than 10 cm in diameter (2) Masses smaller than 10 cm in diameter with the possibility of trauma and heavy bleeding. (3) Masses 3-6 cm in diameter with small masses but with clinical symptoms, or where the nature of other masses cannot be ruled out, need surgical intervention if any of the above points are met. Surgical options: hepatectomy, hemangioma dissection, hemangioma suture, hepatic artery ligation, microwave curettage, radiofrequency thermal destruction, hepatic artery embolization, and other methods.