Pedunculated Hepatic Hemangiomas often Misdiagnosed Despite Their Typical Findings

Background: Hepatic hemangiomas are the most common benign liver tumors which can be often diagnosed radiologically. However despites their typical radiologic findings, giant pedunculated hemangiomas are rare and often misdiagnosed as a supra-renal, retroperitoneal, gastric, or mesenteric mass. Methodology: The authors present a case and the summary of a thorough literature search on this rare disease entity. Results: A 35-year-old male is found to have a 12cm mesenteric mass on computed tomography and undergoes a surgical exploration. Intraoperatively, a large pedunculated hepatic hemangioma from the left lobe of the liver is encountered and removed successfully. A thorough PubMed search reveals a total of 18 publications in English with 24 cases of giant pedunculated hepatic hemangioma, most of which occur in older females, and originate from the left lobe of the liver. These tumors in general retain the typical computed tomography or magnetic resonance imaging findings of an intrahepatic hemangioma. Conclusions: When a peri-hepatic lesion possesses typical radiologic characteristics of a hemangioma, pedunculated hemangioma should be included in the differential diagnosis.