Materiały źródłowe

• #1 Hepatic Hemangiomas: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/177106-overview

  Hemangiomas are the most common benign tumors affecting the liver and usually discovered incidentally. They are mesenchymal in origin, usually solitary, and composed of masses of blood vessels that are atypical or irregular in arrangement and size. Typically, there are large vascular cavities surrounded by a simple layer of endothelial cells, supported by fibrous connective tissue. The majority of these lesions are smaller than 5 cm in diameter. […] The etiology of these lesions remains unknown. Some authorities consider hemangiomas to be benign congenital hamartomas. […] Hepatic hemangiomas may result from abnormal angiogenesis. […] Some authors have reported that steroid therapy, female sex hormones, and pregnancy could increase the size of an already existing hemangioma. […] That said, the focal liver lesion practice guideline of the American College of Gastroenterology (ACG) states: „There has been no clear causative link between hemangiomas and female sex hormones, and thus, it is not recommended to avoid OCP [oral contraceptive pills] or pregnancy in patients with hemangiomas.”

• #1 Hepatic hemangioma – UpToDate

  https://www.uptodate.com/contents/hepatic-hemangioma/print

  Hepatic hemangiomas (also referred to as cavernous hemangiomas because of the cavernous vascular space seen histologically) are the most common benign liver lesion. […] The etiology of hepatic hemangiomas is incompletely understood. They are thought to be vascular malformations or hamartomas of congenital origin that enlarge by ectasia rather than by hyperplasia or hypertrophy.

• #1 Hemangioma of the liver: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/322450

  Doctors are still not sure what causes liver hemangiomas. […] In some cases, liver hemangiomas may be present from birth, but they can also develop at any point during a persons life. They are more common in people aged 30-50 years, and more likely to occur in women than in men. […] Although many people refer to them as tumors, hemangiomas are not malignant and do not become cancerous. There is no evidence to suggest that people who do not treat a liver hemangioma can develop liver cancer.

• #1 Hemangioma of the Liver (Hepatic Hemangioma)

  https://www.healthline.com/health/hepatic-hemangioma

  A liver hemangioma is a tangled network of blood vessels in or on the surface of the liver. […] Doctors arent sure why blood vessels clump together and form a liver hemangioma. However, they do believe that it has a genetic component, which means it tends to run in families. Some liver hemangiomas may be present at birth. […] Pregnant people and those using estrogen replacement therapy have a higher risk of developing a large hemangioma. This is because estrogen may contribute to the growth of liver hemangiomas. […] Women are more likely than men to develop a liver hemangioma. Because estrogen is believed to fuel the growth of a hemangioma, the mass may be larger in women as well. […] People who use hormone replacement therapy to increase their estrogen levels are also at an increased risk of developing a liver hemangioma.

• #1 Hepatic Hemangioma | Texas Children’s

  https://www.texaschildrens.org/content/conditions/hepatic-hemangioma

  Hemangiomas are benign (not cancer) growths of extra blood vessels. […] Genetics (if applicable) There is no known gene that causes hemangiomas and thus genetic testing is unnecessary.

• #1 Cavernous liver hemangioma – Wikipedia

  https://en.wikipedia.org/wiki/Cavernous_liver_hemangioma

  A cavernous liver hemangioma or hepatic hemangioma is a benign tumor of the liver composed of large vascular spaces lined by monolayer hepatic endothelial cells. […] Liver hemangiomas are thought to be congenital in origin with an incidence rate of 0.4 7.3% as reported in autopsy series. […] Hepatic hemangiomas can occur as part of a clinical syndrome, for example KlippelTrnaunay syndrome, OslerWeberRendu syndrome and Von HippelLindau syndrome.

• #1 Liver Hemangioma | Liver Cancer | UPMC Center for Liver Care

  https://www.upmc.com/services/digestive-disorders-center/services/liver-diseases/conditions/liver-cancer/liver-hemangioma

  Hemangiomas are bundles of blood vessels that form benign, or noncancerous, tumors in the liver. […] Researchers aren’t sure why blood vessels in the liver form hemangiomas. […] Some researchers believe that too much vascular endothelial growth factor (VEGF) may lead to liver hemangiomas forming. […] Your cells make VEGF to tell your body to build blood vessels. Researchers need to do more studies on VEGF and liver hemangiomas to be sure.

• #1 Congenital and Infantile Hepatic Hemangioma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK518988/

  IH and CH are both vascular tumors of infancy but differ in their underlying cause and clinical course. The underlying pathogenesis in both cases is only partially understood. In the case of IH, it is theorized lesions form as a product of dysregulation of vasculogenesis and angiogenesis. Hypoxic stress appears to be a triggering signal, prompting over-expression of VEG-F and other angiogenic factors, leading to an abnormal proliferation of fetal endothelial cells. […] In the case of CH, somatic activating mutations are implicated in their pathogenesis. Recent studies have demonstrated mutations in the alleles GNAQ and GNA11 in CH. Interestingly, both RICH and NICH demonstrate similar mutations, suggesting their different clinical behavior may be the result of postnatal factors or epigenetics.

• #1 Liver Hemangioma: What it Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17784-liver-hemangioma

  Scientists arent sure why liver hemangiomas occur. If you get one, you can consider it an anomaly. Some think it might be a birth defect. […] We don’t know what causes them. Some suspect they may be congenital or even genetically inherited. There also appears to be some connection between liver hemangiomas and estrogen. They occur more often and grow faster in females, especially when more estrogen is present, such as during puberty, pregnancy and hormone replacement therapy. […] Alcohol use does not appear to be a risk factor for liver hemangiomas. Its more associated with malignant (cancerous) liver lesions. Alcohol does cause problems for your liver, but not hemangiomas.

• #1 Hemangioma: Symptoms, Diagnosis, and Treatment

  https://www.healthline.com/health/hemangioma

  Hemangiomas of the liver (hepatic hemangiomas) form inside the liver or on its surface. These can be related to infantile hemangiomas, or they can be unrelated. The non-infantile hemangiomas of the liver are thought to be sensitive to estrogen. […] This excess estrogen can spur the growth of liver hemangiomas. Similarly, pregnancy and sometimes oral contraceptive pills can increase the size of hemangiomas.

• #1 Hepatic hemangioma: What internists need to know

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6952297/

  Hepatic hemangioma (HH) is the most common benign liver tumor and it is usually found incidentally during radiological studies. This tumor arises from a vascular malformation; however, the pathophysiology has not been clearly elucidated. […] The pathophysiology of HH is not completely understood, and in some cases, a genetic predisposition has been described. HH arises from a vascular malformation with a growing pattern secondary to dilation rather than hypertrophy or hyperplasia. […] One hypothesis suggest HH results from abnormal angiogenesis and an increase in pro-angiogenic factors. […] Hormones such as estrogens play a role in HH growth, as they are seen more frequently among women and their size increase after hormone replacement therapy (HRT), oral contraceptive pills (OCPs), and pregnancy. The direct mechanisms of hormone effects are unknown, as HH are negative for estrogen and progesterone receptors and current evidence does not support a contraindication of OCPs/HRT/anabolic steroids in patients with HH.

• #1 What Is a Liver Hemangioma?

  https://www.webmd.com/digestive-disorders/liver-hemangioma-overview

  A liver hemangioma is a type of noncancerous (benign) growth in your liver. Your doctor might call it a hepatic hemangioma. […] The reason is unclear. […] Doctors also dont know exactly what triggers a hemangioma to form in your liver. But studies suggest that your genes may be involved. […] Researchers believe that other things may play a role in making the tumor or helping it get bigger. They include: Long-term steroid therapy for a disease or for muscle-building, Using birth control pills for a long time, Pregnancy.

• #1 Real-world data on the clinicopathological traits and outcomes of hospitalized liver hemangioma patients: a multicenter study

  https://atm.amegroups.org/article/view/70525/html

  Adult hepatic hemangioma is the most common benign tumor of the liver. […] In recent years, research on the etiology, pathogenesis, clinical and imaging characteristics, diagnosis, and treatment of hepatic hemangioma has made progress globally, but there is still a lack of evidence from high-quality clinical trials. […] At present, there is no consensus on the clinical features, diagnosis, treatment indications, risk assessment, or treatment strategies for hepatic hemangioma in the literature. […] The presence of Kasabach-Merritt syndrome (thrombocytopenia syndrome) necessitates treatment and is defined as giant hemangioma with bleeding tendency and thrombocytopenia. […] Spontaneous or traumatic rupture of hepatic hemangioma and Kasabach-Merritt syndrome are absolute indications for treatment because of their fatal consequences.

• #1 One stop shop approach for the diagnosis of liver hemangioma

  https://www.wjgnet.com/1948-5182/full/v13/i12/1892.htm

  Hepatic hemangioma is usually detected on a routine ultrasound examination because of silent clinical behaviour. […] The pathogenesis of hemangioma is not entirely understood, the theory of congenital disorder with possible hormonal dependence has been taken into account. […] Hemangiomas are classified into three types: Cavernous, capillary and sclerosing hemangioma. […] The natural history of hemangiomas is variable: Most of them remain stable, some may grow or involute. […] The typical CEUS feature of a hemangioma, regardless of the injected contrast agent, is peripheral nodular enhancement in the arterial phase with progressive centripetal partial or complete fill-in in portal venous phase and complete enhancement in late phase. […] The described appearance is highly suggestive of hemangioma.

• #1 Real-world data on the clinicopathological traits and outcomes of hospitalized liver hemangioma patients: a multicenter study

  https://atm.amegroups.org/article/view/70525/html

  When the diameter of the hepatic hemangioma is greater than 10 cm and continues to grow or increases rapidly within a short time, it may induce symptoms and related complications. […] Most hemangiomas are diagnosed with typical imaging features; however, some suspected hepatic hemangiomas have atypical imaging features and are a concern to clinicians and patients. […] There are currently two types of surgical excision, LAP and laparoscopy. […] Radiofrequency ablation (RFA) is a minimally invasive and effective treatment option for patients with hepatic hemangioma. […] The complication rate of ablation and IE for hepatic hemangioma was lower than that of surgical resection. […] Hemangioma rupture, Kasabach-Merritt syndrome, moderate to severe symptoms, suspected hemangioma with an uncertain clinical diagnosis, and progressive hemangioma should be considered as indications for treatment.

• #1 Spontaneous intracapsular hemorrhage of a giant hepatic cavernous hemangioma: a rare case report and literature review | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-021-01666-z

  Hepatic cavernous hemangioma is the most common type of benign liver tumor. […] The pathogenesis is still unclear. […] It is believed that it may be related to abnormal vasculogenesis and angiogenesis. […] Although hepatic hemangioma rupture and hemorrhage are uncommon complications, they can be lethal. […] Spontaneous intracapsular hemorrhage of cavernous hepatic hemangioma is rare. […] There are only eight Chinese or English reports in the past 26 years, which causes a lack of in-depth understanding. […] The cause of the disease is not clear; it is believed that it may be related to abnormal vasculogenesis and angiogenesis. […] However, reports on hepatic hemangioma with internal hemorrhage are rare, causing a lack of further understanding and ignoring its serious harmfulness.

• #1 Prevalence and Characteristics of Hepatic Hemangioma Associated with Coagulopathy and Its Predictive Risk Factors

  https://www.mdpi.com/2077-0383/11/15/4347

  The number of abnormal coagulation factors was significantly correlated with tumor size, M2BPGi, and HDL cholesterol, among which tumor size was the most significant independent predictor of the number of abnormal coagulation factors. […] The combination of thrombocytopenia, hypofibrinogenemia, and the activation of the fibrinolytic system implicates a situation of continuous coagulation followed by fibrinolysis within the vessels of hemangiomas. […] Our results show that abnormal d-dimer values were most frequently found among the six coagulation factors. […] The consumption of platelets and fibrinogen, in addition to ongoing fibrinolysis, results in intra-tumoral thrombosis or hemorrhage and the subsequent enlargement of the hemangioma. […] Our present study demonstrated that the size of hemangiomas was closely associated with coagulation factors and the increase in tumor size was caused by intra-tumoral thrombosis and subsequent hemorrhage.

• #1 What is changing in indications and treatment of hepatic hemangiomas. A review | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-what-is-changing-in-indications-S1665268119308397

  Hepatic cavernous hemangioma accounts for 73% of all benign liver tumors with a frequency of 0.4-7.3% at autopsy and is the second most common tumor seen in the liver after metastases. […] The pathogenesis of this tumor is not still completely understood, but abnormal vasculogenesis and angiogenesis have been speculated to be involved. […] Some hemangiomas have the receptor for the estrogens and they grown during the puberty, pregnancy (following ovarian stimulation therapy with clomiphene citrate and human chorionic gonadotrophin), or oral contraceptive use, androgen or/and steroid administration. […] The size increase have been suggested from many studies, mainly case report. […] The malignant transformation is practically inexistent. […] The right indications for surgery remain rupture, intratumoral bleeding, Kasabach-Merritt syndrome and organ or vessels compression (gastric outlet obstruction, Budd-Chiari syndrome, etc.) represents the valid indication for surgery and at the same time they are all complications of the tumor itself.

• #1 What is changing in indications and treatment of hepatic hemangiomas. A review | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-what-is-changing-in-indications-S1665268119308397

  The causes of pain should be critically analyzed in case of hepatic hemangioma because more than 50% of the patients with abdominal pain and liver hemangioma have been found to have various gastrointestinal pathologies including cholelithiasis and peptic ulcer disease. […] The Kasabach Merritt syndrome (also known as hemangioma thrombocytopenia syndrome) is a rare but life-threatening disease and represents a valid indication for immediate surgery in patients with hepatic hemangioma. […] Traditionally, surgery had been advocated for most hemangiomas due to a concern for possible rupture. […] However, over the last 25 yr this paradigm has been challenged due to the relatively limited number of cases of rupture reported in the literature.

• #1

  https://journals.lww.com/md-journal/fulltext/2015/08040/surgical_treatment_of_giant_liver_hemangioma.29.aspx

  The size of the hemangioma alone is not a formal indication for surgical intervention, although pain was more frequently observed in patients with larger lesions. Some authors have emphasized that hemangiomas 10 cm in size may have a greater potential for internal bleeding, further growth or rupture, which justified the prophylactic excision of asymptomatic large lesions. […] There are 2 common surgical procedures for the treatment of liver hemangioma, namely enucleation and resection. Some authors advocate formal liver resection while others advocate enucleation. Comparative studies between liver resection and enucleation of the hemangioma have reported that enucleation is associated with less intraoperative bleeding, shorter operation times, lower morbidity, and a shorter hospital stay.

• #1

  https://journals.lww.com/md-journal/fulltext/2015/08040/surgical_treatment_of_giant_liver_hemangioma.29.aspx

  Hemangioma is the most common benign liver tumor, and affects 3% to 20% of the general population. These benign tumors can occur in people of all ages, but are more commonly found in young adult females. The hemangioma is usually asymptomatic and diagnosed incidentally. For most patients, the natural history of cavernous hemangiomas in the liver remains uneventful and surgical intervention can be avoided. […] Indications for surgery include the presence of progressive abdominal symptoms, spontaneous or traumatic rupture, rapidly enlarging lesions, Kasabach-Merritt syndrome and unclear diagnosis. Four types of surgical procedures including liver resection, enucleation, hepatic artery ligation, and liver transplantation have been reported as treatments for liver hemangiomas. Resection and enucleation remain the most commonly used surgical methods.

• #1 Hepatic hemangioma Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/hepatic-hemangioma

  A hepatic hemangioma is the most common type of liver mass that is not caused by cancer. It may be a birth defect. […] Hepatic hemangiomas can occur at any time. They are most common in people in their 30s to 50s. Women get these masses more often than men. The masses are often bigger in size. […] Babies may develop a type of hepatic hemangioma called benign infantile hemangioendothelioma. This is also known as multinodular hepatic hemangiomatosis. This is a rare, noncancerous tumor that has been linked to high rates of heart failure and death in infants. Infants are most often diagnosed by the time they are 6 months old.

• #1 A case report of giant hepatic hemangioma spontaneous regression in adult, non-cirrhotic patient and literature review

  https://www.oatext.com/a-case-report-of-giant-hepatic-hemangioma-spontaneous-regression-in-adult-non-cirrhotic-patient-and-literature-review.php

  Hepatic hemangiomas (HHs) are defines as giant when are larger than 4 cm. […] Their etiology is not well understood, however some do consider them vascular malformations that enlarge through dilation rather than hypertrophy or hyperplasia. It is suggested that hormones could play a key role in the enlargement of these masses. […] To date, a giant liver hemangioma in non-cirrhotic patients which spontaneously shrunk without treatment, has not yet been reported. […] The knowledge about etiopathogeny of HHs remains unclear, with several mechanisms reported including genetic connection, mesenchymal origin or congenital hematoma. […] Although the mechanism is still under debate, the size of hepatic hemangioma in adults may seldom change. […] High VEGF expression, which plays an important role in tumor progression, leads to increased angiogenic formation in hemangioma endothelial cells.

• #1 Prevalence and Characteristics of Hepatic Hemangioma Associated with Coagulopathy and Its Predictive Risk Factors

  https://www.mdpi.com/2077-0383/11/15/4347

  From our investigation of coagulopathy associated with hemangiomas and the literature, we were able to conclude that hemangiomas with a diameter larger than 5 cm were defined as giant hemangiomas and that these tumors had the potential to cause blood coagulation disorder and hemangioma-related complications.

• #2 Hepatic hemangioma – UpToDate

  https://www.uptodate.com/contents/hepatic-hemangioma/print

  Hepatic hemangiomas (also referred to as cavernous hemangiomas because of the cavernous vascular space seen histologically) are the most common benign liver lesion. […] The etiology of hepatic hemangiomas is incompletely understood. They are thought to be vascular malformations or hamartomas of congenital origin that enlarge by ectasia rather than by hyperplasia or hypertrophy.

• #2 Liver hemangioma | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/liver-hemangioma

  It’s not clear what causes a liver hemangioma to form. Doctors believe liver hemangiomas are present at birth (congenital). […] In most people, a liver hemangioma will never grow and never cause any signs and symptoms. But in a small number of people, a liver hemangioma will grow to cause symptoms and require treatment. It’s not clear why this happens.

• #2 Liver Hemangioma – Symptoms, Causes and TreatmentLPC

  https://liverandpancreasclinic.com/blog/2018/03/23/liver-hemangioma/

  Its not clear what causes a liver hemangioma to form. It is probably congenital meaning that youre born with it. It is certainly not familial or genetically inherited. Some associations are observed regarding occurrence and growth of a hemangioma like age, sex, hormonal influence, drugs etcetera. […] Several pharmacologic agents have been postulated to promote its growth. Steroid therapy, estrogen therapy, and pregnancy can increase the size of an already existing hemangioma. […] Hepatic hemangiomas can occur at all ages. Most hepatic hemangiomas are diagnosed in individuals aged 30-50 years. Female patients often present at a younger age and with larger tumors.

• #2 What Is a Liver Hemangioma?

  https://www.webmd.com/digestive-disorders/liver-hemangioma-overview

  A liver hemangioma is a type of noncancerous (benign) growth in your liver. Your doctor might call it a hepatic hemangioma. […] The reason is unclear. […] Doctors also dont know exactly what triggers a hemangioma to form in your liver. But studies suggest that your genes may be involved. […] Researchers believe that other things may play a role in making the tumor or helping it get bigger. They include: Long-term steroid therapy for a disease or for muscle-building, Using birth control pills for a long time, Pregnancy.

• #2 Cavernous liver hemangioma – Wikipedia

  https://en.wikipedia.org/wiki/Cavernous_liver_hemangioma

  A cavernous liver hemangioma or hepatic hemangioma is a benign tumor of the liver composed of large vascular spaces lined by monolayer hepatic endothelial cells. […] Liver hemangiomas are thought to be congenital in origin with an incidence rate of 0.4 7.3% as reported in autopsy series. […] Hepatic hemangiomas can occur as part of a clinical syndrome, for example KlippelTrnaunay syndrome, OslerWeberRendu syndrome and Von HippelLindau syndrome.

• #2 Liver Hemangioma – Symptoms, Causes, Pictures & Treatment

  https://www.hexahealth.com/condition/liver-haemangioma

  Liver haemangiomas are benign growths in the liver. […] Doctors do not know the exact reason why blood vessels cluster and develop into a liver haemangioma. However, here are some possible risk factors of liver haemangioma: […] There may be a genetic predisposition to developing liver haemangiomas, as they tend to run in families. […] Hormonal changes, such as those that occur during pregnancy or with the use of hormone replacement therapy, may increase the risk of developing liver haemangiomas. […] Liver haemangiomas are more common in middle-aged adults, with most cases occurring between the ages of 30 and 50. […] Women are more likely than men to develop liver haemangiomas, possibly due to the hormonal changes that occur during pregnancy. […] A history of liver injury or surgery may increase the risk of developing liver haemangiomas. […] Liver haemangiomas have been associated with other health conditions, such as Klippel-Trenaunay-Weber syndrome and Blue rubber bleb nevus syndrome.

• #2 Hepatic hemangioma: What internists need to know

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6952297/

  Hepatic hemangioma (HH) is the most common benign liver tumor and it is usually found incidentally during radiological studies. This tumor arises from a vascular malformation; however, the pathophysiology has not been clearly elucidated. […] The pathophysiology of HH is not completely understood, and in some cases, a genetic predisposition has been described. HH arises from a vascular malformation with a growing pattern secondary to dilation rather than hypertrophy or hyperplasia. […] One hypothesis suggest HH results from abnormal angiogenesis and an increase in pro-angiogenic factors. […] Hormones such as estrogens play a role in HH growth, as they are seen more frequently among women and their size increase after hormone replacement therapy (HRT), oral contraceptive pills (OCPs), and pregnancy. The direct mechanisms of hormone effects are unknown, as HH are negative for estrogen and progesterone receptors and current evidence does not support a contraindication of OCPs/HRT/anabolic steroids in patients with HH.

• #2

  https://healthmatch.io/liver-disease/hemangioma-liver

  The underlying cause of a liver hemangioma isnt fully understood. There may be certain genetic factors that increase susceptibility. […] One view is that people with a liver hemangioma have issues with the process of blood vessel development. People with the condition may have too much of certain substances that cause blood vessel growth. […] There may be a hormonal component to this condition, as it disproportionately affects women, and hemangioma size increases more in those who are on hormonal oral contraceptive pills and those who have had hormone replacement therapy. Therefore, it is thought that estrogen might play a role in developing liver hemangiomas. […] The cause of liver hemangiomas isnt well understood, but there is thought to be a genetic component. Additionally, hormonal factors (estrogen) may play a role.

• #2 Congenital and Infantile Hepatic Hemangioma – MD Searchlight

  https://mdsearchlight.com/gut-health/congenital-and-infantile-hepatic-hemangioma/

  IH and CH are both types of blood vessel tumors that occur in babies; however, they have different causes and progress differently. The exact reasons why these tumors form aren’t completely understood. […] When it comes to IH, the theory is that these abnormalities are a result of problems with the formation and growth of blood vessels. Conditions with lower oxygen levels may trigger this problem, causing an overproduction of VEG-F and other factors that contribute to the growth of blood vessels, leading to an abnormal increase in a type of cell in the fetus called endothelial cells. […] On the other hand, the formation of CH is associated with certain changes in the structure of genes. Recent research has shown changes in two genes, GNAQ and GNA11, in CH. Interestingly, two types of CH, RICH and NICH, share these changes. This implies that the differences in how these tumors affect patients might be due to factors that occur after birth, or other changes on a genetic level that don’t affect the structure of the genes themselves.

• #2 Hemangioma of the Liver (Hepatic Hemangioma)

  https://www.healthline.com/health/hepatic-hemangioma

  A liver hemangioma is a tangled network of blood vessels in or on the surface of the liver. […] Doctors arent sure why blood vessels clump together and form a liver hemangioma. However, they do believe that it has a genetic component, which means it tends to run in families. Some liver hemangiomas may be present at birth. […] Pregnant people and those using estrogen replacement therapy have a higher risk of developing a large hemangioma. This is because estrogen may contribute to the growth of liver hemangiomas. […] Women are more likely than men to develop a liver hemangioma. Because estrogen is believed to fuel the growth of a hemangioma, the mass may be larger in women as well. […] People who use hormone replacement therapy to increase their estrogen levels are also at an increased risk of developing a liver hemangioma.

• #2 Outcomes of surgery for giant hepatic hemangioma | BMC Surgery | Full Text

  https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-021-01185-4

  The surgical indications for liver hemangioma remain unclear. […] The main indication for surgery is giant (10 cm) liver hemangioma, with or without symptoms. […] Some hemangiomas contain estrogen receptors and grow during pregnancy, oral contraceptive use, or Rogaine and/or steroid administration. […] Thus, female sex hormones play an important role in the development of hepatic hemangioma, and these tumors are more common in women. […] The definition of giant hepatic hemangioma is crucial. […] We believe that the definition of giant hemangioma should be based on diameter 10 cm, as 10-cm hemangiomas can cause more serious symptoms than can 4-cm tumors. […] The case of the female patient with a hepatic hemangioma misdiagnosed as hepatocellular carcinoma clarifies the importance of the accurate diagnosis of hepatic hemangioma.

• #2 Liver Hemangioma: What You Need to Know About this Benign Tumor | Omar Rashid, Medicus Elite

  https://www.toplinemd.com/omar-rashid/liver-hemangioma-what-you-need-to-know-about-this-benign-tumor/

  Made up of tangled blood vessel clumps, liver hemangiomas are among the most common type of liver tumors. […] The medical-scientific community isn’t really sure why these lesions develop. Some think it’s a congenital anomaly that doesn’t indicate any liver problems. […] Regarding hemangioma causes, experts aren’t sure what causes them. As mentioned above, some propose that there might be a hereditary component to these benign lesions. Also, research has pointed out that there’s a connection between these hemangiomas and estrogen. More specifically, they develop more often in women, especially in periods when more estrogen is present in the female body (such as puberty, pregnancy, and during HRT – hormone replacement therapy). […] On the other hand, there seems to be no link between drinking alcohol and hemangioma formation. Heavy alcohol consumption is more associated with cancerous liver growth and other hepatic problems such as cirrhosis.

• #2 Liver Hemangioma: Symptoms, Diagnosis & Treatment – Tua Saúde

  https://www.tuasaude.com/en/liver-hemangioma/

  A liver hemangioma is a small nodule formed by a cluster of blood vessels. This liver finding is normally benign, does not develop into cancer and does not cause symptoms. The causes of liver hemangiomas are not known, however, this problem is more common in women aged between 30 and 50, who have been pregnant or who are taking hormone replacement therapy. […] Treatment for a liver hemangioma should be guided by a liver specialist, but is normally only initiated if the patient presents with symptoms such as abdominal pain or constant vomiting. The doctor will opt to start treatment if there is a risk for the liver hemangioma to be a malignant tumor or when there is a risk for a rupture and bleeding of the vessels.

• #2 Can liver cancer be misdiagnosed as liver hemangioma?

  https://www.icliniq.com/qa/liver-hemangioma/could-my-liver-hemangioma-actually-be-liver-cancer

  Multiple hemangiomas or large hemangioma can cause abdominal pain and discomfort. Hemangiomas are more in females that does not mean that they are not in males. […] Hemangiomas can sometimes present with a larger-sized liver, which can cause pain, fullness, and discomfort on the right side of the upper abdomen. Hemangiomas can also increase in size, typically by 0.1 to 0.3 cm per year, especially in individuals under 30 years of age. […] Hemangiomas are the most common benign (non-cancerous) tumors of the liver. Most people live with them lifelong without any kind of intervention. […] Your previous scans have not identified any small bowel pathology. Usually, it is difficult to detect small bowel tumors or lesions on imaging scans, such as CT scans of the abdomen or MRI, unless their size is large. […] Malignant small bowel tumors, if left untreated for a long time, will definitely metastasize to other organs and cause infiltration of nearby organs. They can also cause bowel obstruction within a few months of appearance.

• #2 Giant hepatic hemangioma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/giant-hepatic-haemangioma-1?lang=us

  Giant hepatic hemangiomas, also known as giant hepatic venous malformations, are relatively uncommon non-neoplastic vascular lesions of the liver, which can be strikingly large and mimic tumors. […] In addition, there is a poor agreement in the literature as to the exact definition of what constitutes a „giant” hepatic hemangioma, as some of the literature defines it as a size 4 cm but others 6 cm or even 10 cm. Either way, they are examples of atypical hepatic hemangiomas. […] Potential complications include: mass effect on adjacent structures (e.g. biliary tree, hepatic vessels), Kasabach-Merritt syndrome (a form of consumptive coagulopathy due to thrombocytopenia), rupture with hemoperitoneum.

• #2 Spontaneous intracapsular hemorrhage of a giant hepatic cavernous hemangioma: a rare case report and literature review | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-021-01666-z

  The incidence of abdominal bleeding caused by ruptured hepatic hemangioma is relatively low (14%) and the mortality is quite high (36-39%). […] Therefore, for patients with clinical symptoms, intense surgery demands and high-risk complications should be actively treated. […] Intracapsular hemorrhage of hepatic cavernous hemangiomas is very rare, which is difficult for us to distinguish from hepatic cyst masses with an intratumoral hemorrhage or even malignant liver tumors. […] Due to the high mortality of tumor rupture, appropriate treatments are recommended as soon as possible after diagnosis.

• #2 What is changing in indications and treatment of hepatic hemangiomas. A review | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-what-is-changing-in-indications-S1665268119308397

  Hepatic cavernous hemangioma accounts for 73% of all benign liver tumors with a frequency of 0.4-7.3% at autopsy and is the second most common tumor seen in the liver after metastases. […] The pathogenesis of this tumor is not still completely understood, but abnormal vasculogenesis and angiogenesis have been speculated to be involved. […] Some hemangiomas have the receptor for the estrogens and they grown during the puberty, pregnancy (following ovarian stimulation therapy with clomiphene citrate and human chorionic gonadotrophin), or oral contraceptive use, androgen or/and steroid administration. […] The size increase have been suggested from many studies, mainly case report. […] The malignant transformation is practically inexistent. […] The right indications for surgery remain rupture, intratumoral bleeding, Kasabach-Merritt syndrome and organ or vessels compression (gastric outlet obstruction, Budd-Chiari syndrome, etc.) represents the valid indication for surgery and at the same time they are all complications of the tumor itself.

• #2

  https://journals.lww.com/md-journal/fulltext/2015/08040/surgical_treatment_of_giant_liver_hemangioma.29.aspx

  Hemangioma is the most common benign liver tumor, and affects 3% to 20% of the general population. These benign tumors can occur in people of all ages, but are more commonly found in young adult females. The hemangioma is usually asymptomatic and diagnosed incidentally. For most patients, the natural history of cavernous hemangiomas in the liver remains uneventful and surgical intervention can be avoided. […] Indications for surgery include the presence of progressive abdominal symptoms, spontaneous or traumatic rupture, rapidly enlarging lesions, Kasabach-Merritt syndrome and unclear diagnosis. Four types of surgical procedures including liver resection, enucleation, hepatic artery ligation, and liver transplantation have been reported as treatments for liver hemangiomas. Resection and enucleation remain the most commonly used surgical methods.

• #2 Real-world data on the clinicopathological traits and outcomes of hospitalized liver hemangioma patients: a multicenter study

  https://atm.amegroups.org/article/view/70525/html

  When the diameter of the hepatic hemangioma is greater than 10 cm and continues to grow or increases rapidly within a short time, it may induce symptoms and related complications. […] Most hemangiomas are diagnosed with typical imaging features; however, some suspected hepatic hemangiomas have atypical imaging features and are a concern to clinicians and patients. […] There are currently two types of surgical excision, LAP and laparoscopy. […] Radiofrequency ablation (RFA) is a minimally invasive and effective treatment option for patients with hepatic hemangioma. […] The complication rate of ablation and IE for hepatic hemangioma was lower than that of surgical resection. […] Hemangioma rupture, Kasabach-Merritt syndrome, moderate to severe symptoms, suspected hemangioma with an uncertain clinical diagnosis, and progressive hemangioma should be considered as indications for treatment.

• #2

  https://journals.lww.com/md-journal/fulltext/2015/08040/surgical_treatment_of_giant_liver_hemangioma.29.aspx

  To the best of our knowledge, the present study is the largest to date reporting on hepatic hemangioma of size 10 cm. We found that both enucleation and liver resection are safe and effective surgical treatments for liver hemangiomas 10 cm. There were no major differences in outcomes when using enucleation and liver resection for liver hemangioma in different regions of the liver. Adjacency to major vascular structures and right or bilateral liver hemangiomas were found to be independent preoperative predictor factors regarding increased intraoperative blood loss.

• #2 Hepatic hemangioma: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000243.htm

  A hepatic hemangioma is a liver mass made of widened (dilated) blood vessels. It is not cancerous. […] A hepatic hemangioma is the most common type of liver mass that is not caused by cancer. It may be a birth defect. […] Babies may develop a type of hepatic hemangioma called benign infantile hemangioendothelioma. This is also known as multinodular hepatic hemangiomatosis. This is a rare, noncancerous tumor that has been linked to high rates of heart failure and death in infants. […] Pregnancy and estrogen-based medicines can cause these tumors to grow.

• #2 A case report of giant hepatic hemangioma spontaneous regression in adult, non-cirrhotic patient and literature review

  https://www.oatext.com/a-case-report-of-giant-hepatic-hemangioma-spontaneous-regression-in-adult-non-cirrhotic-patient-and-literature-review.php

  Usually, they reduce in size only when the VEGF levels change or after selective hepatic artery embolization, while the commonly known natural history of HHs in non-cirrhotics do not include a decrease in size or regression. […] In summary, we have documented and reported the first case of a non-cirrhotic adult woman with a giant HH which had regressed without the use of drugs or procedures.

• #2 What is changing in indications and treatment of hepatic hemangiomas. A review | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-what-is-changing-in-indications-S1665268119308397

  The causes of pain should be critically analyzed in case of hepatic hemangioma because more than 50% of the patients with abdominal pain and liver hemangioma have been found to have various gastrointestinal pathologies including cholelithiasis and peptic ulcer disease. […] The Kasabach Merritt syndrome (also known as hemangioma thrombocytopenia syndrome) is a rare but life-threatening disease and represents a valid indication for immediate surgery in patients with hepatic hemangioma. […] Traditionally, surgery had been advocated for most hemangiomas due to a concern for possible rupture. […] However, over the last 25 yr this paradigm has been challenged due to the relatively limited number of cases of rupture reported in the literature.

• #2 Real-world data on the clinicopathological traits and outcomes of hospitalized liver hemangioma patients: a multicenter study

  https://atm.amegroups.org/article/view/70525/html

  Adult hepatic hemangioma is the most common benign tumor of the liver. […] In recent years, research on the etiology, pathogenesis, clinical and imaging characteristics, diagnosis, and treatment of hepatic hemangioma has made progress globally, but there is still a lack of evidence from high-quality clinical trials. […] At present, there is no consensus on the clinical features, diagnosis, treatment indications, risk assessment, or treatment strategies for hepatic hemangioma in the literature. […] The presence of Kasabach-Merritt syndrome (thrombocytopenia syndrome) necessitates treatment and is defined as giant hemangioma with bleeding tendency and thrombocytopenia. […] Spontaneous or traumatic rupture of hepatic hemangioma and Kasabach-Merritt syndrome are absolute indications for treatment because of their fatal consequences.

• #3 Hepatic hemangioma: What internists need to know

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6952297/

  Hepatic hemangioma (HH) is the most common benign liver tumor and it is usually found incidentally during radiological studies. This tumor arises from a vascular malformation; however, the pathophysiology has not been clearly elucidated. […] The pathophysiology of HH is not completely understood, and in some cases, a genetic predisposition has been described. HH arises from a vascular malformation with a growing pattern secondary to dilation rather than hypertrophy or hyperplasia. […] One hypothesis suggest HH results from abnormal angiogenesis and an increase in pro-angiogenic factors. […] Hormones such as estrogens play a role in HH growth, as they are seen more frequently among women and their size increase after hormone replacement therapy (HRT), oral contraceptive pills (OCPs), and pregnancy. The direct mechanisms of hormone effects are unknown, as HH are negative for estrogen and progesterone receptors and current evidence does not support a contraindication of OCPs/HRT/anabolic steroids in patients with HH.

• #3

• #3

  https://www.kuh.ku.edu.tr/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/liver-hemangioma

  Liver hemangioma is a noncancerous (benign) mass in the liver made up of a tangle of blood vessels. […] It’s not clear what causes a liver hemangioma to form. Doctors believe liver hemangiomas are present at birth (congenital). […] In most people, a liver hemangioma will never grow and never cause any signs and symptoms. But in a small number of people, a liver hemangioma will grow to cause symptoms and require treatment. It’s not clear why this happens. […] Factors that can increase the risk that a liver hemangioma will be diagnosed include: Your age. A liver hemangioma can be diagnosed at any age, but it’s most commonly diagnosed in people ages 30 to 50. […] Women who have been pregnant are more likely to be diagnosed with a liver hemangioma than women who have never been pregnant. It’s believed the hormone estrogen, which rises during pregnancy, may play a role in liver hemangioma growth. […] Medications that affect hormone levels in your body, such as birth control pills, could cause an increase in size and complications if you’ve been diagnosed with a liver hemangioma. But this is controversial.

• #3

  https://healthmatch.io/liver-disease/hemangioma-liver

  The underlying cause of a liver hemangioma isnt fully understood. There may be certain genetic factors that increase susceptibility. […] One view is that people with a liver hemangioma have issues with the process of blood vessel development. People with the condition may have too much of certain substances that cause blood vessel growth. […] There may be a hormonal component to this condition, as it disproportionately affects women, and hemangioma size increases more in those who are on hormonal oral contraceptive pills and those who have had hormone replacement therapy. Therefore, it is thought that estrogen might play a role in developing liver hemangiomas. […] The cause of liver hemangiomas isnt well understood, but there is thought to be a genetic component. Additionally, hormonal factors (estrogen) may play a role.

• #3 A case report of giant hepatic hemangioma spontaneous regression in adult, non-cirrhotic patient and literature review

  https://www.oatext.com/a-case-report-of-giant-hepatic-hemangioma-spontaneous-regression-in-adult-non-cirrhotic-patient-and-literature-review.php

  Hepatic hemangiomas (HHs) are defines as giant when are larger than 4 cm. […] Their etiology is not well understood, however some do consider them vascular malformations that enlarge through dilation rather than hypertrophy or hyperplasia. It is suggested that hormones could play a key role in the enlargement of these masses. […] To date, a giant liver hemangioma in non-cirrhotic patients which spontaneously shrunk without treatment, has not yet been reported. […] The knowledge about etiopathogeny of HHs remains unclear, with several mechanisms reported including genetic connection, mesenchymal origin or congenital hematoma. […] Although the mechanism is still under debate, the size of hepatic hemangioma in adults may seldom change. […] High VEGF expression, which plays an important role in tumor progression, leads to increased angiogenic formation in hemangioma endothelial cells.

• #3 Dr. Altin Cekodhima

  https://www.altincekodhima.com/index.php?cl=en&go=hemangioma

  Liver hemangioma is a noncancerous (benign) mass that occurs in the liver. […] It’s not clear what causes a liver hemangioma to form. Doctors believe liver hemangioma is congenital meaning that you’re born with it. […] Factors that can increase the risk that liver hemangioma will cause signs and symptoms include: Your age. Liver hemangioma can be diagnosed at any age, but it’s most commonly diagnosed in people ages 30 to 50. Your sex. Women are more likely to be diagnosed with liver hemangioma than men are. Pregnancy. Women who have been pregnant are more likely to be diagnosed with a liver hemangioma than women who have never been pregnant. […] The female hormone estrogen, which increases during pregnancy, is believed to cause some liver hemangiomas to grow larger. […] Medications that affect hormone levels in your body, such as birth control pills, could cause complications if you have been diagnosed with liver hemangioma.

• #3 What Is Liver Hemangioma? – Klarity Health Library

  https://my.klarity.health/what-is-liver-hemangioma/

  Haemangioma is a benign (non-cancerous) vascular lesion which is formed from a collection of small blood vessels. […] The main causative agents that contribute to developing liver haemangiomas are still unknown. Some studies suggest that it is usually present earlier in life as a birth anomaly due to genetic disorders. […] In addition, it was found that the hormones are related to the increase in symptoms of hepatic haemangioma. For instance, females who are pregnant or use estrogen therapy, oral contraceptives, or even replacement therapy to reduce menopause symptoms are at a higher risk of developing liver haemangiomas. […] Medications such as steroids, can accelerate the development of an existing hepatic haemangioma. […] Female pregnancies and hormonal therapies can increase the risk of complications of hepatic haemangiomas by increasing their size. For instance, estrogen therapy, oral contraceptives, and therapies reducing menopausal symptoms as well as pregnancy may disrupt the estrogen and progesterone hormone levels. This lead to an increase in the size of liver haemangiomas.

• #3 What is changing in indications and treatment of hepatic hemangiomas. A review | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-what-is-changing-in-indications-S1665268119308397

  Hepatic cavernous hemangioma accounts for 73% of all benign liver tumors with a frequency of 0.4-7.3% at autopsy and is the second most common tumor seen in the liver after metastases. […] The pathogenesis of this tumor is not still completely understood, but abnormal vasculogenesis and angiogenesis have been speculated to be involved. […] Some hemangiomas have the receptor for the estrogens and they grown during the puberty, pregnancy (following ovarian stimulation therapy with clomiphene citrate and human chorionic gonadotrophin), or oral contraceptive use, androgen or/and steroid administration. […] The size increase have been suggested from many studies, mainly case report. […] The malignant transformation is practically inexistent. […] The right indications for surgery remain rupture, intratumoral bleeding, Kasabach-Merritt syndrome and organ or vessels compression (gastric outlet obstruction, Budd-Chiari syndrome, etc.) represents the valid indication for surgery and at the same time they are all complications of the tumor itself.

• #3 Hemangioma Types, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/23365-hemangioma

  Hemangiomas happen when clusters of blood vessels form and grow incorrectly. Experts arent sure exactly why they happen or how they form. […] Several potential risk factors can make hemangiomas more likely to affect you: Age. Hemangiomas typically affect newborns and infants, especially between 2 weeks old and 2 months old. Development at birth. Up to 1 in 5 premature babies will develop a hemangioma. Sex. Hemangiomas are up to four times more likely to affect females. Skin color. Hemangiomas are more common in people with lighter skin. Other health issues. Some conditions are likely to cause hemangiomas. Examples include PHACE syndrome or von Hippel-Lindau disease.

• #3 How Is Liver Hemangioma Treated in Older Adults?

  https://www.icliniq.com/articles/liver-diseases/liver-hemangioma-in-older-people

  Liver hemangioma is a non-cancerous mass that is found in the liver. […] The exact cause of liver hemangioma is still unknown. Many researchers think it is congenital, meaning it is present from birth. Studies found that liver hemangioma runs in certain families and hence suggesting that there can be a genetic cause. However, the risk factors for liver hemangioma include people between 30 and 50 years of age and women who have undergone pregnancy or hormone replacement therapy. […] Although alcohol can cause many liver problems, it cannot cause liver hemangioma. Some researchers believe that prolonged use of steroids for a medical condition or muscle building can accelerate the growth of hemangiomas. […] As the cause of liver hemangioma is unknown, there aren’t any prevention strategies for liver hemangiomas.

• #3 Real-world data on the clinicopathological traits and outcomes of hospitalized liver hemangioma patients: a multicenter study

  https://atm.amegroups.org/article/view/70525/html

  Other factors, such as cases complicated by obstructive jaundice, portal hypertension, or Budd-Chiari syndrome, are also considered indications for hepatic hemangioma treatment. […] Although most clinicians utilize apparent symptoms to guide their hepatic hemangioma treatment decisions, it is important to exclude nonspecific manifestations caused by other lesions before conducting treatment. […] We found that 20.49% of the patients experienced little or no change after treatment, and 0.06% of the patients stated that their health condition deteriorated after treatment. […] The symptoms of hepatic hemangioma and the associated anxiety are generally subjective rather than objective indicators. […] Several previous studies have shown that the growth rate of most hepatic hemangiomas is extremely slow.

• #3 Giant hepatic hemangioma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/giant-hepatic-haemangioma-1?lang=us

  Giant hepatic hemangiomas, also known as giant hepatic venous malformations, are relatively uncommon non-neoplastic vascular lesions of the liver, which can be strikingly large and mimic tumors. […] In addition, there is a poor agreement in the literature as to the exact definition of what constitutes a „giant” hepatic hemangioma, as some of the literature defines it as a size 4 cm but others 6 cm or even 10 cm. Either way, they are examples of atypical hepatic hemangiomas. […] Potential complications include: mass effect on adjacent structures (e.g. biliary tree, hepatic vessels), Kasabach-Merritt syndrome (a form of consumptive coagulopathy due to thrombocytopenia), rupture with hemoperitoneum.

• #3 Hepatic hemangioma ▷ Causes, symptoms & specialists

  https://www.primomedico.com/en/treatment/hepatic-hemangioma/

  It is still unclear what causes hepatic hemangioma formation. Potential growth factors promoting the development of hepatic hemangiomas are considered to be oral contraceptive use or pregnancy. Although, it is still uncertain as to how these hormones influence the growth of a hemangioma. […] For any benign tumor, the theoretical possibility of it turning into a malignant cancer is present. In the case of hepatic hemangiomas, however, this risk is very small.

• #3 Real-world data on the clinicopathological traits and outcomes of hospitalized liver hemangioma patients: a multicenter study

  https://atm.amegroups.org/article/view/70525/html

  When the diameter of the hepatic hemangioma is greater than 10 cm and continues to grow or increases rapidly within a short time, it may induce symptoms and related complications. […] Most hemangiomas are diagnosed with typical imaging features; however, some suspected hepatic hemangiomas have atypical imaging features and are a concern to clinicians and patients. […] There are currently two types of surgical excision, LAP and laparoscopy. […] Radiofrequency ablation (RFA) is a minimally invasive and effective treatment option for patients with hepatic hemangioma. […] The complication rate of ablation and IE for hepatic hemangioma was lower than that of surgical resection. […] Hemangioma rupture, Kasabach-Merritt syndrome, moderate to severe symptoms, suspected hemangioma with an uncertain clinical diagnosis, and progressive hemangioma should be considered as indications for treatment.

• #3 Hepatic hemangioma | Lima Memorial Health System

  https://www.limamemorial.org/health-library/HIE%20Multimedia/1/000243

  A hepatic hemangioma is the most common type of liver mass that is not caused by cancer. It may be a birth defect. […] Babies may develop a type of hepatic hemangioma called benign infantile hemangioendothelioma. This is also known as multinodular hepatic hemangiomatosis. This is a rare, noncancerous tumor that has been linked to high rates of heart failure and death in infants. […] Pregnancy and estrogen-based medicines can cause these tumors to grow.

• #3 Liver Hemangioma: Causes & Treatments – Acibadem Health Point – ACIBADEM Hospitals – Acibadem Health Group

  https://www.acibademhealthpoint.com/liver-hemangioma-causes-treatments/

  Liver Hemangioma: Causes & Treatments A liver hemangioma is a benign liver tumor. […] Looking at what causes liver hemangiomas, we find both genetic and hormonal reasons. It’s key to know this for rightly handling this liver issue. […] Problems with genetics are big in causing liver hemangiomas. For people with a background in liver hemangiomas, the risk goes up. This happens due to changes in certain genes, making abnormal blood vessels in the liver, causing liver hemangiomas. Research shows these genetic changes play a key part in all this. […] Changes in hormone levels also affect liver hemangiomas. Especially, can relate to estrogen levels. This is why you see more liver hemangiomas in women. Things like pregnancy, menopause, and using hormonal birth control can affect these tumors. This shows how hormones and liver health are linked. […] The cause is not clear, but genes and hormones matter. Family history and estrogen might make them grow.

• #4 Prevalence and Characteristics of Hepatic Hemangioma Associated with Coagulopathy and Its Predictive Risk Factors

  https://www.mdpi.com/2077-0383/11/15/4347

  Hepatic hemangiomas are well known as the most common benign tumors of the liver and are rarely complicated by blood coagulopathy, although coagulation disorders, including thrombocytopenia and hypofibrinogenemia, are sometimes associated with hemangiomas. […] The aim of this study was to investigate the prevalence and characteristics of hepatic hemangiomas associated with coagulopathy, to elucidate the causes of coagulopathy, and to identify the predictive factors of hemangioma-related complications. […] The prevalence of hepatic hemangiomas associated with coagulopathy was relatively high and became more frequent with increases in tumor size. Predictive factors of hemangioma-related complications were found to be a tumor size of >5 cm in diameter and coagulopathy, especially the elevation of d-dimer.

• #5 Prevalence and Characteristics of Hepatic Hemangioma Associated with Coagulopathy and Its Predictive Risk Factors

  https://www.mdpi.com/2077-0383/11/15/4347

  From our investigation of coagulopathy associated with hemangiomas and the literature, we were able to conclude that hemangiomas with a diameter larger than 5 cm were defined as giant hemangiomas and that these tumors had the potential to cause blood coagulation disorder and hemangioma-related complications.

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