Removal of a giant hepatic hemangioma by enucleation after selective hepatic artery embolization

Abstract

Hemangioma is the most common primary tumor of liver. It is found mostly in a single lobe. When the size is larger than 5 cm, it is called a giant hemangioma. Hemangiomas are usually asymptomatic. Size is not the only criteria when deciding surgery. Indications for surgery are growth of the hemangioma during follow-up, pain, uncertainty in differential diagnosis and spontaneous rupture. Bleeding control during surgery is a major problem. Selective hepatic artery embolization to reduce bleeding alone is effective, but there are not detailed studies about this issue. Studies in the literature are limited to combination of different methods. Our case was a 45 years old postmenopausal patient with abdominal pain who had a successful surgery after embolization. Enucleation was carried out one day after embolization, with minimal bleeding. The patient was followed for 13 months without any morbidity.