Therapeutic Options of Giant Liver Hemangioma

Liver hemangiomas are often asymptomatic, smaller and diagnosed incidentally. A giant hemangioma is defined as a lesion with a diameter greater than 5 cm. Giant hemangiomas can become symptomatic and may cause mechanical complications related to tumour size [1]. Also, complications such as coagulation disorders, bleeding and traumatic rupture can occur during conservative management period [1]. Asymptomatic and noncomplicated giant hemangiomas can be safely observed with lower adverse events and the hemangioma size alone is not supported for indication of surgery even for very large lesion [2-4]. Severe incapacitating symptomatology or complications occurred during observation are justifiable of surgical management [26]. Surgery is the most effective therapeutic modality to treat liver hemangioma [4,6]. A hemangioma can be removed by enucleation or liver resection however, most authors advocated enucleation procedure. In very rare and exceptional condition, Liver transplantation can be considered as a treatment option for hemangioma [7-10]. Other therapeutic options as Radiofrequency ablation (RFA) and transcatheter arterial embolization (TAE) can be considered in some situations. This mini-review provides a general view of the therapeutic options employed to treat giant liver hemangioma.