An atypical case of hepatic cavernous hemangioma

Abstract

Introduction: The case of an atypical hepatic angiocavernoma is referred. The lesion, first described as a hypoechogenic area compared to the surrounding parenchyma, with anechogenic shoots inside, suggestive for vascular structures developed one year later into a totally asonic area with frayed margins. This change is very unusual and uncommon for this kind of lesions.

Case presentation: The case of a 74-year old caucasian male, complaining of slight dyspeptic symptoms (post-prandial fullness and bloating) is referred. The routine blood tests were all normal. Abdominal ultrasound showed a large, roughly round-shaped lesion (diameter 14 cm) in the VIII hepatic segment diagnosed as hepatic angiocavernoma, which turned unexpectedly in a cystic like lesion one year later.

Conclusion: The atypical angioma's degeneration could account for one of the causes of the patient's exitus. It could be related to blood seizure by the large hepatic angioma due to the intratumoural haemorrhage.

Figure 1

Hepatic hemangioma (first presentation). Large, roughly roundish formation, located in the VIII hepatic segment, 14 cm in diameter, basically hypoechoic compared to the surrounding parenchyma. It was chacterised by several anechoic shoots with a serpentine-like course, very suggestive of vascular structures.

Figure 2

Development of hepatic hemangioma. Voluminous anechoic formation (axis longer than 20 cm), with non-definite and frayed lips, occupying a large portion of the right lobe.