Multiple sclerosing hemangiomas mimicking hepatocellular carcinoma: A case report

Abstract

Hepatocellular carcinoma is a prevalent malignant tumor affecting the liver, and surgical resection and liver transplantation are the primary treatment options for early-stage HCC patients. However, the presence of benign hepatic tumors with similar imaging characteristics to HCC poses challenges in diagnosing and treating the disease, often resulting in misdiagnosis and inappropriate treatment. This case report presents a 52-year-old female patient who exhibited space-occupying liver lesions on abdominal CT and MRI scans. Based on pathological sections from other hospitals, liver malignancy was highly suspected, and hepatocellular tumor was diagnosed preoperatively. But the tumor markers of the patient were all within the normal range. After evaluating the overall condition of the patient, we finally chose the diagnosis and treatment of dissection and partial hepatectomy. Surprisingly, the final diagnosis of postoperative pathology was sclerosing hemangioma. The patient recovered well and was discharged 2 weeks later. Hepatic sclerosing hemangioma is an extremely rare disease that can be easily mistaken for malignant liver tumors due to absence of typical imaging presentations. The diagnosis also needs to be differentiated from other benign tumors, such as liver adenoma and liver abscess, according to the medical history, symptoms, and auxiliary examinations. Therefore, special attention should be given to the diagnosis and treatment of sclerosing hemangioma.

Keywords: MRI; case report; histopathology; liver; sclerosing hemangioma.

Figure 1.

An abdominal magnetic resonance imaging scan of a 52-year-old woman showed multiple space-occupying lesions in the liver. The irregular mass in the right lobe of the liver showed multiple separate enhancement shadows in the interior and margin of the mass, with continuous enhancement of the arteries, veins, and delayed phase.

Figure 2.

The gross manifestation of a large mass in the right lobe of liver was 10*6.5*6.5 cm, the capsular was complete, and multiple gray and white areas were visible on the tumor section.