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Observational Study
. 2025 Jun;19(3):682-691.
doi: 10.1007/s12072-024-10756-5. Epub 2024 Nov 29.

Clinical characteristics and managements of congenital hepatic hemangioma: a cohort study of 211 cases

Xue Gong #  1 , Min Yang #  1 , Zixin Zhang #  1 , Tong Qiu #  1 , Jiangyuan Zhou  1 , Wei Shan  2 , Xuepeng Zhang  1   3 , Yuru Lan  1 , Pingqian Bao  4 , Zilong Zhou  1 , Congxia Yang  1 , Yujia Zhang  1 , Tianliang Li  5 , Jing Guo  6 , Jun Guo  7 , Guoyan Lu  8 , Feiteng Kong  9 , Yongbo Zhang  9 , Siyuan Chen  3 , Yi Ji  10
Affiliations
Observational Study

Clinical characteristics and managements of congenital hepatic hemangioma: a cohort study of 211 cases

Xue Gong et al. Hepatol Int. 2025 Jun.

Abstract

Background: Hepatic hemangiomas can be classified into three morphologic patterns: focal (congenital hepatic hemangiomas [CHHs]), multifocal, and diffuse. We aimed to identify the clinical characteristics of CHH and evaluate the changes in CHH management at our institution over the last 2 decades.

Methods: This was a retrospective cohort study of children diagnosed with CHH who were managed at 8 investigation sites. The primary outcome was changes in CHH size in patients at the last follow-up. The primary exposure of interest was management modality in 2 study periods (2003-2012 versus 2013-2022).

Results: Two hundred and eleven patients were analyzed. Four different subtypes of CHH were identified. Rapidly involuting CHH patients had complete involution/nearly complete involution, with a median age of 12.0 months. Noninvoluting CHH presented no change in CHH size. Partially involuting CHH patients presented with partial involution and had a stable tumor size at a median age of 16.0 months. Postnatally proliferating CHHs had an initial postnatal increase in CHH lesion size and underwent involution at a median age of 27.0 months. Further analysis revealed that management strategies for CHHs have shifted over time, with the proportion of patients receiving expectant management increasing from 35.4% before 2013 to 77.7% after 2013 (difference, 42.3%; 95% confidence interval 29.3-53.3%). The survival rate of patients with CHH was high (98.6%).

Conclusions: We documented 4 subtypes of CHHs. We found that expectant management strategies have increasingly replaced invasive interventions in patients with CHH over the past 2 decades.

Research registration unique identifying number (uin): We have already registered at Clinicaltrials.gov. The UIN number is NCT03331744.

Keywords: Clinical characteristics; Complication; Congenital hepatic hemangioma; Management; Subtype.

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Conflict of interest statement

Declarations. Conflict of interest: Xue Gong, Min Yang, Zixin Zhang, Tong Qiu, Jiangyuan Zhou, Wei Shan, Xuepeng Zhang, Yuru Lan, Pingqian Bao, Zilong Zhou, Congxia Yang, Yujia Zhang, Tianliang Li, Jing Guo, Jun Guo, Guoyan Lu, Feiteng Kong, Yongbo Zhang, Siyuan Chen and Yi Ji declare that they have no conflict of interest. Ethical approval: This study was approved by the ethics committee on medical research of each participating site. Written informed consent was not needed from the patients’ parents or legal guardians because of the retrospective design of this study and the anonymous collection of analytical data.

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