Spontaneous rupture of hemangioma of the liver: treatment with transcatheter hepatic arterial embolization.

A case of spontaneous rupture of a cavernous hemangioma of the liver with a successful hepatic resection after transcatheter hepatic arterial embolization is reported. Twenty-eight cases of spontaneous rupture of hepatic hemangioma have been reported in the medical literature. Each of the cases (19 adults and nine children) were reviewed, including the present one reported here. Surgical treatments were carried out on 20 patients, of whom only five survived. Ruptured hemangiomas ranged in size from 3.0 to 25.0 cm, and many were located on the inferior surface of the liver. Surgical resection should be considered for a large hepatic hemangioma located on the inferior surface of the liver if the tumor has a high probability of rupture. Once the hemangioma has ruptured, emergent hepatic resection is recommended for low-risk patients, whereas high-risk patients should receive transcatheter hepatic arterial embolization prior to elective hepatic resection.