Hepatic hemangioma medical therapy: Difference between revisions

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{{Hepatic hemangioma}}
{{Hepatic hemangioma}}
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==Overview==
Observation is recommended among patients with small hemangiomas (less than 4 cm), whereas asymptomatic patients are followed up with periodic radiological examination.<ref name="Jr2010">{{cite journal|last1=Jr|first1=Marcelo AF Ribeiro|title=Spontaneous rupture of hepatic hemangiomas: A review of the literature|journal=World Journal of Hepatology|volume=2|issue=12|year=2010|pages=428|issn=1948-5182|doi=10.4254/wjh.v2.i12.428}}</ref><ref name=hemangioma>Subtypes of hepatic hemangioma. Dr Yuranga Weerakkody et al. Radiopaedia 2015. http://radiopaedia.org/articles/hepatic-haemangioma-3. Accessed on October 26, 2015</ref> There are no medical therapies to treat hemangioma.


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==Management==
*Observation is recommended among patients with small hemangiomas (less than 4 cm).<ref name=Tawfik>{{cite journal|title=Adult hepatic hemangioma: an updated review with focus on the natural course and treatment options|journal=Abdomen|year=2015|issn=23781351|doi=10.14800/abdomen.908}}</ref>
*Asymptomatic patients are managed with routine radiological examination.<ref name="Jr2010">{{cite journal|last1=Jr|first1=Marcelo AF Ribeiro|title=Spontaneous rupture of hepatic hemangiomas: A review of the literature|journal=World Journal of Hepatology|volume=2|issue=12|year=2010|pages=428|issn=1948-5182|doi=10.4254/wjh.v2.i12.428}}</ref>
*Hemangiomas less than 10 cm are usually not treated, even before pregnancy. Patients planning pregnancy with a hemangioma > 10 cm, resection may be indicated due to the risk of a possible rupture.<ref name="EhrlRothaug2012">{{cite journal|last1=Ehrl|first1=Denis|last2=Rothaug|first2=Katharina|last3=Herzog|first3=Peter|last4=Hofer|first4=Bernhard|last5=Rau|first5=Horst-Günter|title=“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma|journal=HPB Surgery|volume=2012|year=2012|pages=1–14|issn=0894-8569|doi=10.1155/2012/891787}}</ref><ref name="Assy2009">{{cite journal|last1=Assy|first1=Nimer|title=Characteristics of common solid liver lesions and recommendations for diagnostic workup|journal=World Journal of Gastroenterology|volume=15|issue=26|year=2009|pages=3217|issn=1007-9327|doi=10.3748/wjg.15.3217}}</ref>
*Hepatic hemangioma usually remain stable over time and surgical treatment is not recommended unless there is signs of rapidly growing hepatic hemangioma or when the size at the presentation is more than 15 cm.<ref name=Tawfik>{{cite journal|title=Adult hepatic hemangioma: an updated review with focus on the natural course and treatment options|journal=Abdomen|year=2015|issn=23781351|doi=10.14800/abdomen.908}}</ref>


==Medical Therapy==
==Medical Therapy==
Most cavernous hepatic hemangiomas are treated only if there is persistent [[pain]].
*There are no medical therapies to treat hemangioma.
 
Treatment for [[infantile hemangioendothelioma]] depends on the child's growth and development. The following treatments may be needed:
 
*Inserting a material in a blood vessel of the liver to block it (embolization).
*Tying off (ligation) a liver artery.
*Medications for [[heart failure]].
*Surgery to remove the tumor.


==References==
==References==
{{Reflist|2}}


{{Reflist|2}}
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Latest revision as of 01:56, 27 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]

Overview

Observation is recommended among patients with small hemangiomas (less than 4 cm), whereas asymptomatic patients are followed up with periodic radiological examination.[1][2] There are no medical therapies to treat hemangioma.

Management

  • Observation is recommended among patients with small hemangiomas (less than 4 cm).[3]
  • Asymptomatic patients are managed with routine radiological examination.[1]
  • Hemangiomas less than 10 cm are usually not treated, even before pregnancy. Patients planning pregnancy with a hemangioma > 10 cm, resection may be indicated due to the risk of a possible rupture.[4][5]
  • Hepatic hemangioma usually remain stable over time and surgical treatment is not recommended unless there is signs of rapidly growing hepatic hemangioma or when the size at the presentation is more than 15 cm.[3]

Medical Therapy

  • There are no medical therapies to treat hemangioma.

References

  1. 1.0 1.1 Jr, Marcelo AF Ribeiro (2010). "Spontaneous rupture of hepatic hemangiomas: A review of the literature". World Journal of Hepatology. 2 (12): 428. doi:10.4254/wjh.v2.i12.428. ISSN 1948-5182.
  2. Subtypes of hepatic hemangioma. Dr Yuranga Weerakkody et al. Radiopaedia 2015. http://radiopaedia.org/articles/hepatic-haemangioma-3. Accessed on October 26, 2015
  3. 3.0 3.1 "Adult hepatic hemangioma: an updated review with focus on the natural course and treatment options". Abdomen. 2015. doi:10.14800/abdomen.908. ISSN 2378-1351.
  4. Ehrl, Denis; Rothaug, Katharina; Herzog, Peter; Hofer, Bernhard; Rau, Horst-Günter (2012). ""Incidentaloma" of the Liver: Management of a Diagnostic and Therapeutic Dilemma". HPB Surgery. 2012: 1–14. doi:10.1155/2012/891787. ISSN 0894-8569.
  5. Assy, Nimer (2009). "Characteristics of common solid liver lesions and recommendations for diagnostic workup". World Journal of Gastroenterology. 15 (26): 3217. doi:10.3748/wjg.15.3217. ISSN 1007-9327.