How could a haemangioma cause pain?
Most giant hepatic haemangiomas are asymptomatic (~80%), but patients may experience pain from thrombosis, infarction, hemorrhage, or stretching of the liver's Glisson capsule.
Is this at risk for haemorrhage?
Yes. Although an uncommon event (1-4%), the risk of mortality is high (~35-40%). (4)
Should a giant haemangioma be resected?
The answer depends on the individual case and whether the haemangioma is symptomatic (e.g. hemorrhage or consumption coagulopathy ("Kasabach-Merritt" syndrome), but in general, imaging surveillance is preferred. (2)
Dynamic sequence with 8 mL of Gadavist.
- peripheral nodular discontinuous enhancement
- progressive filling in on the later phases