A physical examination revealed a hepatic hemangioma. Is it serious?

Author: Yang Zhiying, Chief Physician of China-Japan Friendship Hospital

Reviewer: Shi Wenzai, attending physician at Peking University International Hospital

Many people will find "hepatic hemangioma" during their health check-ups. When they see the word "tumor", they often feel inexplicably nervous. Is it benign or malignant? What are the symptoms? Is it harmful to the human body? What should we pay attention to in our lives?

Today, we will answer all your questions one by one.

1. Is hepatic hemangioma benign or malignant?

Hepatic hemangiomas are benign diseases that rarely become malignant, but they will continue to grow.

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Hepatic hemangioma is an abnormal proliferative lesion of the liver blood vessels. The reason is that during the embryonic development period, some small micro-vessels may develop abnormally, forming an abnormal vascular mass. This abnormal vascular mass will slowly proliferate and grow larger until one day, we can see and discover it in imaging examinations.

We have seen in clinic that the most common group of hepatic hemangioma is young and middle-aged women, but from the census, the incidence rate of men and women is the same. Previous census data showed that the incidence rate of hepatic hemangioma is about 3%, which means that 3 out of 100 people will be found to have hepatic hemangioma during physical examination.

However, due to the effect of estrogen, women's hemangiomas may grow relatively faster than men's. Therefore, among the hemangiomas seen clinically, women's hemangiomas are two to three times more common than men's.

2. What are the possible symptoms of hepatic hemangioma?

Generally speaking, more than 90% of hemangiomas seen in clinical practice are smaller than 5 cm, and such hemangiomas usually do not have any symptoms. However, some patients did not have any symptoms before, but after a physical examination found a hemangioma in the liver, they felt uncomfortable in the area, and this feeling of discomfort is usually related to mental factors.

Hemangiomas larger than 5 cm may have some symptoms, but the occurrence of these symptoms is usually related to its growth rate and location.

The liver is divided into two lobes, the right lobe of the liver is relatively large, accounting for more than 70% of the entire liver. Hemangiomas in this area usually have to grow to a large size before symptoms appear. We have also done statistics, and the probability of symptoms appearing in a 10cm hemangioma is only about 30%.

The left lobe of the liver is relatively small, accounting for only about 25% of the entire liver volume. When the hemangioma in this area grows, it is easy to grow outside the liver, thereby compressing the stomach. Therefore, hemangiomas in the left liver often have some symptoms, that is, a feeling of fullness after eating. For example, if the same 10cm hemangioma grows in the left liver, 80% of them will have symptoms.

In addition, if it grows very fast, it will cause the tension of the liver capsule to increase, which will cause swelling and pain.

What does it mean to grow fast? Generally speaking, we consider that if it can grow 2cm a year, the growth rate is very fast. This kind of fast-growing hepatic hemangioma is rare. For the vast majority of hepatic hemangiomas, the annual growth rate is measured in millimeters, and rarely exceeds 1cm.

Therefore, the symptoms of hepatic hemangioma are closely related to its size, location, and growth rate.

3. What harm may hepatic hemangioma cause to the human body?

Hepatic hemangiomas usually do not cause any harm to the body.

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However, as the hemangioma continues to grow, it may continuously push the liver. At the same time, hemangiomas in the marginal zone are prone to rupture due to external forces. Once ruptured, abdominal bleeding will occur. This is the most serious complication of hemangioma, called hemangioma rupture, but its incidence is very low.

Also, as the hemangioma grows larger, it will have a pushing effect on the surrounding tissues. The hemangioma pushes and compresses the stomach, causing a feeling of fullness in the stomach, which is very uncomfortable. This is a symptom of compression.

Another thing is that when the hemangioma grows to a certain size, it will bleed inside the tumor. Because the hemangioma grows too fast, some liver hemangiomas will rupture inside, causing the hemangioma to suddenly grow larger and cause pain. This is called intratumoral bleeding.

In addition, due to some mechanism factors, coagulation is caused inside the hemangioma, resulting in a large consumption of coagulation factors and platelets, leading to hypofibrinogenemia, hypoplateletemia, etc., and KM syndrome may occur. It will cause some clinical manifestations, which will only occur in very serious cases.

4. What should patients with hepatic hemangioma pay attention to in their daily lives?

Hemangiomas smaller than 5 cm and located in the liver have no impact on the human body and patients can live freely like normal people.

If you have a relatively large hemangioma or an exophytic hemangioma, you should be careful in your life. What should you be careful about? Don't do too many confrontational sports, such as football, basketball, boxing, wrestling, and other intense confrontational sports.

In addition, when you have symptoms, don't drink too much or overeat, just maintain a healthy lifestyle. Of course, this is what healthy people should do too.