BACKGROUND: Although for asymptomatic hepatic hemangiomas conservative management is generally recommended, factors affecting the disease course are still not very well understood. AIM: To determine disease characteristics of cavernous hemangioma and factors affecting its progression in patients from a general hepatology clinic in Tehran, Iran. METHODS: We reviewed medical records of 198 patients with cavernous hemangioma of the liver visiting a large private hepatology clinic in Tehran from 1997 to 2007. Of a total of 198 cases, 129 could be followed up for a period of 3.2 ± 2.5 years, and 80 of these had 1-5 repeated sonographies. RESULTS: Patients were between 27 and 84 years old (mean age: 44.3 ± 10.9 years), and 131 (66.2%) were female. Thirty-six patients (18.2%) had giant hemangiomas. Abdominal pain was the primary reason for evaluation in 100 (50.5%) patients. Abdominal pain at the beginning of the follow-up was significantly associated with having irritable bowel syndrome [odds ratio (OR)=8.3; 95% confidence interval (CI): 3.1-28.7] or other gastrointestinal diseases (OR=3.9; 95% CI: 2.6-10.2), but not with hemangioma size, number, or location. During follow-up, having a single giant lesion at the time of diagnosis, adjusted for age, sex, and presence of irritable bowel syndrome, was a strong predictor of persistent pain during follow-up (OR=11.1; 95% CI: 3.2-38.6). In repeated sonographies, 35% showed an increased size, which was significantly associated only with having a single lesion (P=0.04). CONCLUSION: Many symptoms in hepatic hemangioma are attributable to accompanying gastrointestinal diseases. Patients with a single giant lesion are more likely to have persistent pain, and single lesions are more likely to grow in size.
BACKGROUND: Although for asymptomatic hepatic hemangiomas conservative management is generally recommended, factors affecting the disease course are still not very well understood. AIM: To determine disease characteristics of cavernous hemangioma and factors affecting its progression in patients from a general hepatology clinic in Tehran, Iran. METHODS: We reviewed medical records of 198 patients with cavernous hemangioma of the liver visiting a large private hepatology clinic in Tehran from 1997 to 2007. Of a total of 198 cases, 129 could be followed up for a period of 3.2 ± 2.5 years, and 80 of these had 1-5 repeated sonographies. RESULTS:Patients were between 27 and 84 years old (mean age: 44.3 ± 10.9 years), and 131 (66.2%) were female. Thirty-six patients (18.2%) had giant hemangiomas. Abdominal pain was the primary reason for evaluation in 100 (50.5%) patients. Abdominal pain at the beginning of the follow-up was significantly associated with having irritable bowel syndrome [odds ratio (OR)=8.3; 95% confidence interval (CI): 3.1-28.7] or other gastrointestinal diseases (OR=3.9; 95% CI: 2.6-10.2), but not with hemangioma size, number, or location. During follow-up, having a single giant lesion at the time of diagnosis, adjusted for age, sex, and presence of irritable bowel syndrome, was a strong predictor of persistent pain during follow-up (OR=11.1; 95% CI: 3.2-38.6). In repeated sonographies, 35% showed an increased size, which was significantly associated only with having a single lesion (P=0.04). CONCLUSION: Many symptoms in hepatic hemangioma are attributable to accompanying gastrointestinal diseases. Patients with a single giant lesion are more likely to have persistent pain, and single lesions are more likely to grow in size.
Authors: B Descottes; D Glineur; F Lachachi; D Valleix; J Paineau; A Hamy; M Morino; H Bismuth; D Castaing; E Savier; P Honore; O Detry; M Legrand; J S Azagra; M Goergen; M Ceuterick; J Marescaux; D Mutter; B de Hemptinne; R Troisi; J Weerts; B Dallemagne; C Jehaes; M Gelin; V Donckier; R Aerts; B Topal; C Bertrand; B Mansvelt; L Van Krunckelsven; D Herman; M Kint; E Totte; R Schockmel; J F Gigot Journal: Surg Endosc Date: 2002-10-08 Impact factor: 4.584
Authors: Wilson W C Ng; Y S Cheung; K F Lee; John Wong; Simon C H Yu; Paul S F Lee; Paul B S Lai Journal: Hong Kong Med J Date: 2007-10 Impact factor: 2.227