Liver & intrahepatic bile ducts
Benign / nonneoplastic

Topic Completed: 1 February 2012

Minor changes: 1 August 2020

Revised: 25 January 2019, last major update February 2012

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Hemangioma[TI] liver[TI] free full text[sb]

See also: Soft tissue topic

Deepali Jain, M.D.
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Cite this page: Jain D. Hemangioma. website. Accessed August 10th, 2020.
Definition / general
  • Most common primary hepatic tumor
  • Usually an incidental finding, found in 1% of routine autopsies and 20% of autopsies with extensive investigation
  • More common in adults than children, 75% in women, who are more likely symptomatic
  • 10% enlarge with followup, may be related to pregnancy or oral contraceptives
  • No known risk of malignant transformation
  • Associated with multiple focal nodular hyperplasia syndrome
  • Fibrotic tumors may be precursor of solitary necrotic nodules
  • Capillary: solitary capillary hemangiomas are extremely rare
  • Cavernous: giant cavernous hemangiomas (> 4 - 10 cm) rarely rupture and require resection
  • Excision or observation (may involute)
Gross description
  • Solitary (70 - 90%), usually 2 - 4 cm, tumors up to 20 cm are overrepresented in studies of excisions
  • Soft, red purple, well circumscribed; subcapsular or deep
  • Tumors collapse when sectioned as blood oozes out
Microscopic (histologic) description
  • Variably sized vascular spaces lined by flat endothelial cells and myxoid or fibrous stroma
  • Large fibrous septa may trap bile ducts
  • Variable thrombosis, calcification, phleboliths
  • Increased fibrosis with age of lesion may obliterate lumen
  • Border may be irregular
  • May see cavernous hemangioma-like vessels (HLV) in adjacent liver
Microscopic (histologic) images

Images hosted on other servers:

Images contributed by Dr. Shilpa Jain:

Cavernous hemangioma

Positive stains
Differential diagnosis
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