Retroperitoneal hemangiomas are almost always of the cavernous hemangioma subtype 2.
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Clinical presentation
They tend to be asymptomatic, especially in the early stages of their development, but when present, symptoms are non-specific and due to mass effect on the adjacent anatomic structures.
Radiographic features
CT and MRI
Haemangiomas are generally well defined with round or lobular margins, and with low attenuation, low signal intensity on T1-weighted imaging, and high signal intensity on both T2-weighted imaging and heavily T2-weighted imaging relative to skeletal muscle.
Calcified phleboliths, when visualized, have very low signal intensity on both T1-weighted imaging and T2-weighted imaging, are better visualized on CT, and are strongly suggestive of the diagnosis.
Non-parenchymal hemangiomas in the abdomen usually demonstrate progressive enhancement 2.
Treatment and prognosis
Treatment is conservative, with surgical removal reserved for symptomatic lesions or to establish a tissue diagnosis ref.