Giant liver hemangioma: the role of female sex hormones and treatment.

Hepatic hemangiomas are the most common focal liver lesions and are especially prevalent in women. Giant hemangiomas are defined as hemangiomas of at least 4 cm in diameter and the majority remains stable in size over time. However, in some cases hemangiomas display growth and give rise to symptoms because of their space-occupying effect. Causes for the enlargement of the tumors are unknown, but a role of female sex hormones has been suggested. Therefore, hormone therapy should be avoided in patients who became symptomatic. In patients with important symptoms, disease control can be obtained by transcatheter arterial embolization. In selected patients, especially in case of Kasabach-Merritt syndrome, there is a good indication for liver transplantation.