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Atypical Hepatic Hemangioma: A Case Study

Hemangiomas are benign vascular tumors caused by an increase of blood vessels lined with endothelium. Diagnostic imaging such as sonography, computed tomography (CT), and contrast-enhanced magnetic resonance imaging (CE-MRI) can be used to detect hepatic hemangiomas, which are typically noted as incidental findings. However, in cases where hepatic hemangiomas demonstrate atypical appearances, this may suggest a possible malignancy. In such instances, a liver biopsy may be necessary for pathologic confirmation. A case is provided of a large hepatic mass that was initially detected on CT and further evaluated with sonography. Sonographic evaluation revealed characteristics suspicious for possible malignancy, including highly enlarged size, heterogeneous echotexture, and lobular contour. A biopsy ultimately determined the mass to be a cavernous hepatic hemangioma. The atypical sonographic appearance of the hepatic hemangioma in this case is worthy of consideration such that sonographers and the interpreting physician are aware of various presentations of this pathology.