7 |
56/F |
Generalized bone pain, abdominal pain and abdominal swelling due to hepatic mass |
NA |
NA |
Liver and bone with numerous capillary angiomas consistent with hemangiomatosis. Cystic spaces lined by thin, homogeneously stained endothelial cells. Areas of tumor with numerous intraluminal red blood cells. |
Prednisone |
Died after 2 weeks |
8 |
30/F |
Hepatosplenomegaly, anemia and thrombocytopenia |
NA |
Liver weighed 6,790 g, was reddish brown, with numerous dark soft areas and whitish discoloration. |
Hepatic parenchyma replaced by hemorrhagic cystic tumors. Similar vascular lesion was seen in the spleen, bone marrow, intestine, and peripancreatic lymph nodes. |
Radiotherapy Splenectomy |
Died 12 months after first presentation due to consumptive coagulopathy |
9 |
22/F |
Right upper abdominal pain |
NA |
Both hepatic lobes with innumerable irregular, sometimes confluent reddish nodules of 0.3-2 cm |
Numerous irregularly formed slit-like blood vessels lined by endothelium and slight focal portal fibrosis close to the central vein. The portal triads showed capillary sprouting. The liver capsule was retracted by bands containing capillaries and collagenous fibers. |
Stoppage of drug |
Regression of lesions |
3 |
35/F |
Abdominal pain, weight loss, night sweats and fever |
NA |
Multiple purple nodules < 2 cm found throughout the tumor; mostly beneath the Glisson’s capsule |
Cavernous and diffuse, hemangiomatosis and hemorrhage within the tumor. Innumerable, confluent vascular channels lined by flat endothelial cells linked the hemangiomas. |
Left hepatectomy |
Recurrence and growth into the right hepatic lobe after two years of surgery. Still progressing at 6 years of follow up. |
10 |
50/F |
Tenderness in right upper abdominal quadrant |
Yes |
Size: 17×14×9 cm, multiple blood-filled honey comb areas of 3 mm to 3 cm |
Cavernous hemangioma surrounded by hepatic parenchyma. Vascular channels lined by flattened endothelial cells. No cellular atypia |
Right hepatectomy |
No mass detected on ultrasonography 9 months post-surgery |
11 |
33/F |
Abdominal distension, edema and hepatomegaly |
NA |
NA |
Prominent cavernous vascular proliferation and fibrosis without angiosarcomatous components |
None |
Patient expired due to liver failure 10 days after admission |
12 |
33/F |
Abdominal distension and shortness of breath |
NA |
NA |
Variably dilated non-anastomotic vascular spaces lined by flat endothelial cells (CD 34 +). |
NA |
Died of liver failure after 12 days while waiting for liver transplant |
13 |
78/M |
Abdominal pain and distension |
Yes |
NA |
Cavernous hemangioma with irregularly dilated non-anastamotic vascular spaces lined by flat endothelial cells alternating with normal hepatic parenchyma |
None |
Improvement of discomfort and quality of life after 9 months follow up. |
14 |
35/F |
Epigastric pain and abdominal fullness |
Yes |
The resected tumor was 20× 14× 8.5 cm in size and 910 g in weight |
Hemangiomatous lesions were scattered around the Glisson’s capsule |
Right hepatectomy |
Discharged on POD9 without identifiable lesions |
15 |
68/M |
Asymptomatic |
NA |
NA |
Endothelial-lined sinusoidal proliferation with erythrocyte content, consistent with hepatic hemangiomatosis |
None |
Stable at two years of follow up |
16 |
59/M |
Asymptomatic |
NA |
NA |
H&E showed hemangiomas with (CD34+, CD31+, anti-desmin negative) no cellular atypia. |
NA |
Died due to hepatic failure |
17 |
50/F |
Abdominal pain, hepatomegaly and dyspnea |
Yes |
Well-defined sponge-like reddish brown mass. Remaining parenchyma with similar small lesion. |
Main mass with variable-sized vascular spaces, lined by endothelial cells. Multiple scattered small hemangiomas also present. |
Liver transplant |
Stable for 1.5 years after surgery |
18 |
83/F |
Abdominal distension and hepatomegaly |
NA |
Multiple characteristic dark red nodules on liver surface (laparoscopic finding) |
Irregularly dilated vascular spaces, mostly close to the portal tract, lined by endothelial cells (CD34+ and CD31+) without cellular atypia |
Bevacizumab |
Died 12 months after diagnosis due to multiple organ failure (KMS, hemolytic anemia, heart failure, DIC) |
19 |
62/M |
Asymptomatic |
NA |
NA |
Focal areas of sinusoidal dilatations lined by flattened endothelial cells. |
NA |
NA |
20 |
29/F |
H/O Endometriosis and received OCPs |
Yes |
Lesion in segment IVa with surrounding changes and a well-defined lesion containing 6.5-cm blood clot in segment IVb |
Disseminated aggregate of blood vessels lined by endothelium without atypia. |
Stoppage of drug and left liver lobectomy |
No recurrent liver lesion after 1 year of surgery. |
21 |
40/F |
Abdominal pain and distension |
Yes |
NA |
DHH with a giant hemangioma. No mitosis. STAT6, WT1, Desmin, p53, D2-40 were negative. |
Chemotherapy, trans-arterial embolization and Liver transplant |
Good condition after 6 months of follow-up. |
4 |
63/M |
Abdominal bloating and constipation |
Yes |
NA |
NA |
None |
NA |
6 |
62/M |
Backache, Hepatomegaly |
NA |
NA |
Lesion filled with red blood cells, lined by flat endothelial cells (CD34+) without atypia. |
None |
Good condition after 6 months of follow-up. |
22 |
56/F |
Chronic abdominal discomfort |
Yes |
NA |
NA |
NA |
NA |
Our case |
37/F |
Right upper quadrant fullness and shortness of breath |
Yes |
Well encapsulated, dark red to tan-brown colored masses and few perilesional cherry-colored honeycomb foci. |
Microscopic insinuation of the vascular lesion margins into the normal hepatic sinusoids. Lesions with variably-sized to large, thin-walled, non-anastomosing vascular spaces, and irregularly attenuated thick muscle walls. Vascular spaces lined by single layer of endothelial cells. Fibrin thrombi were noted within these vascular spaces. Stroma with fibrosis, myxoid degeneration, hyalinization, and calcification. |
Surgical enucleation |
Good condition after 6 months of follow-up. |