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In addition, discrimination of synchronous lesions that have a different nature is also important knowing that up to 25–50% of liver lesions less than 2 cm detected in cancer patients may be benign . US sensitivity for metastases detection varies depending on the examiner's experience and the equipment used and ranges between 40 and 80% .
A cavernous liver hemangioma or hepatic hemangioma is a benign tumor of the liver composed of large vascular spaces lined by monolayer hepatic endothelial cells. It is the most common benign liver tumour, and is usually asymptomatic and diagnosed incidentally on radiological imaging or during laparotomy for other intra-abdominal issues.
Currently, if the hepatic adenoma is >5 cm, increasing in size, symptomatic lesions, has molecular markers associated with HCC transformation, rising level of liver tumor markers such as alpha fetoprotein, the patient is a male, or has a glycogen storage disorder, the adenoma is recommended to be surgically removed. [7]
Infantile hemangiomas in the liver are found in 16% of all liver hemangiomas. Its sizes are usually less than 1 to 2 cm in diameter. It may show a "flash-filling" phenomenon in which there is a fast enhancement of the contrast material in the lesion instead of slow, centripetal, nodular filling of the lesions in usual hemangiomas.
Cavernous hemangiomas are erroneously called the most common benign tumors of the liver. [14] Usually one malformation exists, but multiple lesions can occur in the left or right lobe of the liver in 40% of patients. [3] Their sizes can range from a few millimeters to 20 centimetres. Those over 5 cm are often referred to as giant hemangiomas. [3]
In one series of 302 patients, the three-year survival rates for lesions >5 cm, 2.1 to 5 cm, and ≤2 cm were 59, 74, and 91%, respectively. [66] A large randomized trial comparing surgical resection and RFA for small HCC showed similar four-year survival and less morbidities for patients treated with RFA. [ 67 ]
In the axial plane, the caudate lobe should normally have a cross-section of less than 0.55 of the rest of the liver. [2] Other ultrasound studies have suggested hepatomegaly as being defined as a longitudinal axis > 15.5 cm at the hepatic midline, or > 16.0 cm at the midclavicular line. [17] [18]
It is the third most common liver tumor in children, the most common benign vascular tumor of the liver in infancy, and the most common symptomatic liver tumor during the first 6 months of life. [14] These hemangioendotheliomas have 2 growth phases: an initial rapid growth phase, which is followed by a period of spontaneous involution (usually ...
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