When do I need surgery for hepatic hemangioma? The main treatment for hepatic hemangioma is surgical resection, and there are also interventional treatments. There are no clear and effective oral drug treatment options. The consensus is that ruptured hepatic hemangiomas or giant hemangiomas causing thrombocytopenia must be treated by surgical resection. However, there is still a debate on how large a hemangioma should be surgically resected in the absence of these serious problems, due to different historical stages of understanding and based on the results of different studies. Some scholars believe that hemangiomas larger than 5 cm in diameter, or even larger than 4 cm, are called giant hemangiomas and can be considered for surgical resection. With the advancement of understanding, more and more scholars believe that it is more appropriate to compare the benefits and risks of surgery and set the surgical resection standard at greater than 8 cm or 10 cm. In fact, whether or not a hemangioma requires surgical resection is a question that needs to be considered in conjunction with all aspects of the situation. First, it depends on whether the hemangioma is relatively large, whether it grows superficially or near important structures, and whether it grows in a convex and distended manner, which increases the risk of rupture and thrombocytopenia. Secondly, whether the hemangioma continues to increase in size each year, which may pose a greater risk in predictable situations. Then look to see if the patient has symptoms associated with the hemangioma, except for other diseases. Some patients with anxiety about a problem will have various uncomfortable symptoms, and the first class should be clear. The judgment of surgery is more complicated and requires a visit to the hospital to an experienced professional hepatobiliary surgeon to make a judgment, surgery or follow-up plan. How to follow up the changes of hepatic hemangioma? Since the exact mechanism of the occurrence and growth of hepatic hemangioma is not very clear, we are not yet able to fully explain the evolution of the disease of hepatic hemangioma. It is now believed that gender and age are closely related to the changes in the development of hepatic hemangioma. We found that hepatic hemangiomas are mostly seen in women, with a male to female ratio of 1:5. It is believed that there is a relationship between hepatic hemangiomas and estrogenic changes. In addition, adult patients with hepatic hemangioma are commonly found between the ages of 40 and 50. Hepatic hemangiomas may arise from a congenital malformation of the blood vessels, which is different from congenital infantile hemangiomas in other parts of the body, and is mainly found in adulthood. The trend of hemangioma development varies with age. Some hemangiomas grow to a certain point and stop growing with age. Another approximately 20% of hemangiomas continue to grow and eventually bring on a variety of symptoms, leading to secondary lesions and even life-threatening conditions. Recent long-term follow-up studies have found that some hemangiomas also shrink and decrease in size on their own. If a hemangioma is found and does not require surgical treatment, it only needs to be closely monitored for growth changes. We recommend that this follow-up be done for the first time in about six months, followed by annual physical examinations. Enhanced CT is recommended for the first diagnosis and review. The follow-up observation of volume changes can be done by ultrasound, which is economical and not harmful to the body, and further clarification by CT examination if there are changes. During the observation process, if you find that the hemangioma continues to grow, or if symptoms appear, it is recommended that you consult a professional doctor to receive treatment. For patients who are considered to have hepatic hemangioma found by ultrasound in physical examination, neither let it go nor be overly nervous. The first reminder is to go to the hospital for further enhanced CT examinations to make a definitive diagnosis and to determine the need for surgical treatment. The second reminder is to follow it closely and check it regularly. For hemangioma with huge size, rapid growth, obvious symptoms and coagulation disorder, timely surgery is required. In particular, in case of rupture of hemangioma and emergency bleeding, it is important to fight for more time and seek emergency medical treatment nearby.