SPR Unknown # 88 -- FINAL

Peter Marcovici

Abstract

Infantile Hepatic Hemangioma


Publication Date: 2013-05-29

History

4 month old asymptomatic boy with enlarged liver found at well child visit.

Findings

Ultrasound demonstrates well demarcated hypoechoic nodules with increased Doppler flow.

MRI demonstrates multuple masses with homogeneous low signal on T1 and increased signal on T2 and a characteristic centripetal contrast enhancement pattern.

Diagnosis

Infantile Hepatic Hemangioma

Discussion

Hepatic hemangioma is the most common primary liver mass in a neonate with the differential diagnosis of neonatal liver masses including mesesnchymal hamartoma,, hepatoblastoma , and metastatic neuroblastoma.

Hepatic hemangiomas are typically diagnosed during the first months of life. They may be single or multiple and frequently involve a large portion of the liver. They are vascular spaces lined by endothelial cells similar to hemangiomas in other parts of the body. They may present with high output cardiac failure or consumptive coagulopathy and/or hepatomegaly.

Lesions that have atypical imaging or clinical course may require biopsy.

Treatment varies from watch and wait for those that are asymptomatic to medical, endovascular, and surgical for those with associated heart failure and/or consumptive coagulopathy. As with other hemangiomas, the natural history is one of proliferation followed by involution.

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