A Safely Resected, Very Large Hepatic Hemangioma

A 32-year-old woman underwent medical evaluation for painless hepatomegaly. Triphasic computed tomography of the liver revealed multiple hepatic hemangiomas, the largest in the right hepatic lobe (diameter 27 cm). Clinical analysis revealed mild pancytopenia, normal liver function tests, and α-fetoprotein 2.05 ng/mL. The patient was kept under surveillance, and on 1-year follow-up the right hepatic hemangioma had increased to a diameter of 29 cm (Figure 1). As the remaining unaffected liver volume of the patient was 35%, an extended right hepatectomy with cholecystectomy was performed (Figure 2). Histopathology reported a cavernous hemangioma 25 × 20 × 5 cm in size and 4,100 g in weight, with multiple infarcts and acute and chronic re-canalized thrombosis (Figure 3). After 1-year follow-up, the patient remained asymptomatic and her pancytopenia resolved