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Case Report on Rare Presentation of Hepatic Cavernous Haemangioma with Diffuse Hemangiomatosis from Yekatit 12 Hospital Medical College Addis Ababa, Ethiopia

Received: 22 September 2025     Accepted: 4 October 2025     Published: 11 December 2025
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Abstract

Hepatic hemangiomas are the most common liver tumors. They are usually small and asymptomatic, and most often detected incidentally due to the increasing use of imaging modalities. While hemangiomas can occur at any age, they are most commonly found in individuals in their 4th to 6th decade. The majority of haemangiomas are less than 5 cm in size, while those larger than 10 cm are classified as giant hemangiomas. Most of the hemangiomas are solitary, but in 40% of cases, it may involve both right and left lobes and in rare cases, it is associated with diffuse hemangiomatosis. Most hemangiomas are asymptomatic but rarely they may present as an abdominal mass or pain. Large lesions located in the left lobe of the liver may cause pressure effects on adjacent structures such as stomach and bile duct causing nausea leading to anorexia, nausea and jaundice. Rarely large hemangiomas may compress Inferior Vena cava and patients may present with lower limb edema. The diagnosis of hepatic haemangioma mostly depends on cross-sectional imaging. Modalities like CT and MRI are used to diagnose hemangioma and to rule out other differential diagnoses, such as cysts, hepatic adenomas, hepatocellular carcinoma, and distant metastases. Laboratory tests like α-fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen 125 (CA 125) and cancer antigen 19-9 (CA19-9) are important to help rule out malignant lesions. Most hemangiomas do not require any surgical management. However, in patients who present with bothersome symptoms, have a larger size (greater than 10 cm), experience complications like rupture, or have lesions where malignancy cannot be ruled out, surgical treatment should be considered. In our case, the patient presented with compression effects and was diagnosed with a huge hemangioma with hemangiomatous. Resection was performed, and the patient was relieved of symptoms after the surgical intervention.

Published in International Journal of Medical Research and Innovation (Volume 1, Issue 1)
DOI 10.11648/j.ijmri.20250101.14
Page(s) 28-31
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Diffuse Hepatic Hemangiomatosis, Cavernous Hemangioma, Oral Contraceptives, Surgery

References
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[2] Ota T, Kondo S, Kato K, Hirano S, Ambo Y, Tanaka E, et al. A rare case of cavernous hemangioma accompanied with diffuse hepatic hemangiomatosis. Surg Case Rep. 2020 Sep 29; 6(1):251.
[3] Giannitrapani L, Soresi M, La Spada E, Cervello M, D'Alessandro N, Montalto G. Sex hormones and risk of liver tumor. Ann N Y Acad Sci. 2006 Nov; 1089:228-36.
[4] Baek S, Sloane CE, Futterman SC. Benign liver cell adenoma associated with use of oral contraceptive agents. Ann Surg. 1976 Mar; 183(3):239-42.
[5] Neuberger J, Nunnerley HB, Davis M, Portmann B, Laws JW, Williams R. Oral-contraceptive-associated liver tumours: occurrence of malignancy and difficulties in diagnosis. Lancet. 1980 Feb 9; 315(8163):273-6.
[6] Sharma V, Aggarwal A, Singla R, Kalra N, Chawla YK. Giant hemangioma causing Budd-Chiari syndrome. J Clin Exp Hepatol. 2014 Dec; 4(4):380-1.
[7] Westwood ME, Joore MA, Grutters JPC, Redekop WK, Armstrong N, Lee K, et al. Contrast-enhanced ultrasound using SonoVue compared with contrast-enhanced computer tomography and contrast-enhanced magnetic resonance imaging for the characterization of focal liver lesions and detection of liver metastases: a systematic review and cost-effectiveness analysis. Health Technol Assess. 2013; 17(16):1-243.
[8] Nakanuma Y. Non-neoplastic nodular lesions in the liver. Pathol Int. 1995 Oct; 45(10):703-14.
[9] Schwartz SI, Husser WC. Cavernous hemangioma of the liver: a single institution report. Ann Surg. 1987 May; 205(5):456-63.
[10] Jackson NR, Hauch A, Hu T, Buell JF, Slakey DP, Kandil E. The Safety and Efficacy of Approaches to Liver Resection: A Meta-Analysis. JSLS. 2015 Jan-Mar; 19(1): e2014.00186.
[11] Ponnatapura J, Kielar A, Burke LMB, Lockhart ME, Abualruz AR, Tappouni R, et al. Hepatic complications of oral contraceptive pills and estrogen on MRI: controversies and update - Adenoma and beyond. Clin Imaging. 2021; 80:87-103.
[12] Abdel Wahab M, El Nakeeb A, Ali MA, Mahdy Y, Shehta A, Abdulrazek M, et al. Surgical management of giant hepatic hemangioma: single center's experience with 144 patients. J Gastrointest Surg. 2018; 22(4):849-58.
[13] Yamashita S, Okita K, Harada K, Hirano A, Kimura T, Kato A, et al. Giant cavernous hepatic hemangioma shrunk by use of sorafenib. Clin J Gastroenterol. 2013 Feb; 6(1):55-62.
[14] Zhang J, Ye Z, Tan L, Luo J. Giant hepatic hemangioma regressed significantly without surgical management: a case report and literature review. Front Med (Lausanne). 2021 Aug 19; 8:712324.
[15] Zhou JX, Huang JW, Wu H, Zeng Y. Successful liver resection in a giant hemangioma with intestinal obstruction after embolization. World J Gastroenterol. 2013; 19(19):2974-8.
[16] Terkivatan T, Vrijland WW, Den Hoed PT, De Man RA, Hussain SM, Tilanus HW, et al. Size of lesion is not a criterion for resection during management of giant liver haemangioma. Br J Surg. 2002; 89(10):1240.
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    Desta, G., Tilahun, T., Assefa, G., Lebeza, Y. (2025). Case Report on Rare Presentation of Hepatic Cavernous Haemangioma with Diffuse Hemangiomatosis from Yekatit 12 Hospital Medical College Addis Ababa, Ethiopia. International Journal of Medical Research and Innovation, 1(1), 28-31. https://doi.org/10.11648/j.ijmri.20250101.14

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    ACS Style

    Desta, G.; Tilahun, T.; Assefa, G.; Lebeza, Y. Case Report on Rare Presentation of Hepatic Cavernous Haemangioma with Diffuse Hemangiomatosis from Yekatit 12 Hospital Medical College Addis Ababa, Ethiopia. Int. J. Med. Res. Innovation 2025, 1(1), 28-31. doi: 10.11648/j.ijmri.20250101.14

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    AMA Style

    Desta G, Tilahun T, Assefa G, Lebeza Y. Case Report on Rare Presentation of Hepatic Cavernous Haemangioma with Diffuse Hemangiomatosis from Yekatit 12 Hospital Medical College Addis Ababa, Ethiopia. Int J Med Res Innovation. 2025;1(1):28-31. doi: 10.11648/j.ijmri.20250101.14

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  • @article{10.11648/j.ijmri.20250101.14,
      author = {Getachew Desta and Tsion Tilahun and Gezahegn Assefa and Yitayal Lebeza},
      title = {Case Report on Rare Presentation of Hepatic Cavernous Haemangioma with Diffuse Hemangiomatosis from Yekatit 12 Hospital Medical College Addis Ababa, Ethiopia},
      journal = {International Journal of Medical Research and Innovation},
      volume = {1},
      number = {1},
      pages = {28-31},
      doi = {10.11648/j.ijmri.20250101.14},
      url = {https://doi.org/10.11648/j.ijmri.20250101.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmri.20250101.14},
      abstract = {Hepatic hemangiomas are the most common liver tumors. They are usually small and asymptomatic, and most often detected incidentally due to the increasing use of imaging modalities. While hemangiomas can occur at any age, they are most commonly found in individuals in their 4th to 6th decade. The majority of haemangiomas are less than 5 cm in size, while those larger than 10 cm are classified as giant hemangiomas. Most of the hemangiomas are solitary, but in 40% of cases, it may involve both right and left lobes and in rare cases, it is associated with diffuse hemangiomatosis. Most hemangiomas are asymptomatic but rarely they may present as an abdominal mass or pain. Large lesions located in the left lobe of the liver may cause pressure effects on adjacent structures such as stomach and bile duct causing nausea leading to anorexia, nausea and jaundice. Rarely large hemangiomas may compress Inferior Vena cava and patients may present with lower limb edema. The diagnosis of hepatic haemangioma mostly depends on cross-sectional imaging. Modalities like CT and MRI are used to diagnose hemangioma and to rule out other differential diagnoses, such as cysts, hepatic adenomas, hepatocellular carcinoma, and distant metastases. Laboratory tests like α-fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen 125 (CA 125) and cancer antigen 19-9 (CA19-9) are important to help rule out malignant lesions. Most hemangiomas do not require any surgical management. However, in patients who present with bothersome symptoms, have a larger size (greater than 10 cm), experience complications like rupture, or have lesions where malignancy cannot be ruled out, surgical treatment should be considered. In our case, the patient presented with compression effects and was diagnosed with a huge hemangioma with hemangiomatous. Resection was performed, and the patient was relieved of symptoms after the surgical intervention.},
     year = {2025}
    }
    

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    AU  - Getachew Desta
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    AB  - Hepatic hemangiomas are the most common liver tumors. They are usually small and asymptomatic, and most often detected incidentally due to the increasing use of imaging modalities. While hemangiomas can occur at any age, they are most commonly found in individuals in their 4th to 6th decade. The majority of haemangiomas are less than 5 cm in size, while those larger than 10 cm are classified as giant hemangiomas. Most of the hemangiomas are solitary, but in 40% of cases, it may involve both right and left lobes and in rare cases, it is associated with diffuse hemangiomatosis. Most hemangiomas are asymptomatic but rarely they may present as an abdominal mass or pain. Large lesions located in the left lobe of the liver may cause pressure effects on adjacent structures such as stomach and bile duct causing nausea leading to anorexia, nausea and jaundice. Rarely large hemangiomas may compress Inferior Vena cava and patients may present with lower limb edema. The diagnosis of hepatic haemangioma mostly depends on cross-sectional imaging. Modalities like CT and MRI are used to diagnose hemangioma and to rule out other differential diagnoses, such as cysts, hepatic adenomas, hepatocellular carcinoma, and distant metastases. Laboratory tests like α-fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen 125 (CA 125) and cancer antigen 19-9 (CA19-9) are important to help rule out malignant lesions. Most hemangiomas do not require any surgical management. However, in patients who present with bothersome symptoms, have a larger size (greater than 10 cm), experience complications like rupture, or have lesions where malignancy cannot be ruled out, surgical treatment should be considered. In our case, the patient presented with compression effects and was diagnosed with a huge hemangioma with hemangiomatous. Resection was performed, and the patient was relieved of symptoms after the surgical intervention.
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