Early Treatment for Symptomatic Giant Hepatic Hemangioma: Report of Three Cases and Literature Review

Hemangiomas are the most common benign tumors of the liver. Most of them remain stable over time. Fewer than 10% of cases undergo enlargement and only some of them cause symptoms. When a hemangioma keeps growing_@and become symptomatic, it can be managed by surgery, Transcatheter Arterial Embolization (TAE) and Radiofrequency Ablation (RFA). In our experience, we suggest early intervention without delay and we preferred surgical resection. We report three cases of symptomatic giant hemangioma of different sizes (6, 11 and 22 cm, respectively). They had symptoms included abdominal distention, pain, poor appetite, bilateral legs pitting edema and one of them presented as intractable hiccup and was misdiagnosed as gastrointestinal reflux. All of them were treated by surgery and their symptoms were all relieved. Their postoperative courses were uneventful. In two of our cases, they had symptoms more than one year and their tumors grow up over 10 cm with_@compression on the inferior vena cava tightly. Early surgical resections in symptomatic giant hepatic hemangiomas may make operation more safely in cases without marked surgical contraindication and not high risks patients. In this report, we also review the literatures about the treatment of symptomatic hepatic hemangiomas.