Do not prescribe abdominal ultrasound (or other imaging) follow-up for patients with asymptomatic hepatic hemangiomas smaller than 10 cm and without history of chronic liver disease.

Oct 17, 2018

Do not prescribe abdominal ultrasound (or other imaging) follow-up for patients with asymptomatic hepatic hemangiomas smaller than 10 cm and without history of chronic liver disease.

Type of practice

Imaging

Age

Adult, Geriatric

Topic Area

Gastroenterology

Hepatic hemangiomas are the most common non-cystic benign liver lesions, with a prevalence of up to 20% in the general population, and sizes ranging from a few millimeters to more than 20 cm. They result from an abnormality in angiogenesis and have no malignant potential. In asymptomatic patients without a history of chronic liver disease and with hemangiomas smaller than 10 cm, imaging follow-up is not indicated. Follow-up should be reserved for symptomatic patients or for those with hemangiomas larger than 10 cm, due to the potential for related complications. In the latter case, for hemangiomas measuring between 10 and 15 cm, follow-up should be performed with ultrasound because of its low cost and ease of repetition without risk to the patient. For hemangiomas larger than 15 cm, given the difficulty in accurately assessing size changes with ultrasound, magnetic resonance imaging (MRI) is recommended.

Sources

1. European Association for the Study of the Liver (EASL). EASL Clinical Practice Guidelines on the management of benign liver tumours. J Hepatol 2016;65:386-98. doi: 10.1016/j.jhep.2016.04.001.
2. Klotz T, Montoriol PF, Da Ines D, et al. Hepatic haemangioma: Common and uncommon imaging features. Diagn Interv Imaging 2013; 94:849–859. doi: 10.1016/j.diii.2013.04.008.
3. Pompili M, Ardito F, Brunetti E, et al. Benign liver lesions 2022: Guideline for clinical practice of Associazione Italiana Studio del Fegato (AISF), SIRM, SIC, SIUMB, AICEP, SITO, SIAPEC-IAP - Part II – Solid lesions. Dig Liv Dis 2022;54:1614-1622. doi: 10.1016/j.dld.2022.08.031.

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.