Hepatic hemangioma medical therapy: Difference between revisions

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==Medical Therapy==
==Medical Therapy==
*Patients with small hemangiomas (less than 4 cm) are managed by observation.
*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>
*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>
*Hemangiomas less than 10 cm should generally not be treated, even before a pregnancy. In case of a planned pregnancy and a size more than 10 cm, due to the risk of a possible rupture, a definitive treatment should be discussed.<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>
*Hemangiomas less than 10 cm are usually not treated, even before pregnancy. Patients planning pregnancy with a hemangioma > 10 cm, a definitive treatment is controversial 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>
*Conservative management is preferred for most of the patients.<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>
*Conservative management is preferred for most of the patients.<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>



Revision as of 19:58, 4 December 2015

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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]

Medical Therapy

  • Observation is recommended among patients with small hemangiomas (less than 4 cm).
  • Asymptomatic patients are followed up with periodic radiological examination.[1]
  • Hemangiomas less than 10 cm are usually not treated, even before pregnancy. Patients planning pregnancy with a hemangioma > 10 cm, a definitive treatment is controversial due to the risk of a possible rupture.[3][4]
  • Conservative management is preferred for most of the patients.[5]
  • Hepatic hemangioma 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.[5]

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. 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.
  4. 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.
  5. 5.0 5.1 "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.