Causes | Hemangioma of the liver – Is it dangerous?

Causes

The causes of hemangioma of the liver are largely unknown. They may be congenital and may not cause any symptoms for a lifetime. In women under the strong influence of female hormones, as is the case during pregnancy or when taking the “pill”, these benign tumors can be observed more frequently.

Growth of pre-existing hemangiomas of the liver can also occur during pregnancy, so that the hormonal factor plays a decisive role. It has been proven that the hormonal change in the female body has an effect on the growth of hemangiomas of the liver. Progesterone and estrogen play an important role here.

As these hormones are also found in oral contraceptives (“the pill”), increased growth can also occur when they are used. If haemangiomas are known in a pregnant woman, they do not necessarily cause discomfort, but their size and location should be checked regularly to avoid possible complications such as bleeding. This can be done in the standard ultrasound examinations, but can also be monitored in additional appointments as required.

MRI can be used as an alternative sectional image procedure, and computed tomography would be too much radiation exposure for both mother and child. A hemangioma of the liver usually has no effect on the unborn child. Depending on the preparation, the pill contains a hormone composition similar to that produced by the body of a pregnant woman.

Taking the Pill simulates pregnancy for the female body. The hormones it contains are usually estrogen and progesterone. These have been shown to have an influence on the growth of hemangiomas of the liver. If a hemangioma is known in a woman, regular checks for changes such as size growth should be carried out by ultrasound examinations as part of contraception using the pill.

Diagnosis

The diagnosis of a hemangioma of the liver is in most cases a random diagnosis during an imaging procedure such as ultrasound. It can also be observed in computed tomography or magnetic resonance imaging. At the beginning of all diagnostics is the medical history, the medical consultation, in which specific questions are asked about the cause of any symptoms.

Very often, however, patients with a hemangioma in the liver do not suffer from any complaints, or the existing symptoms are very unspecific. In any case, the diagnosis is made using the above mentioned examination methods. If there is any uncertainty, one may consider taking a sample, but special care must be taken to avoid major bleeding.

The samples obtained are then examined under the microscope and provide certainty as to what the event is. Computed tomography provides a slice image of the area to be examined obtained with X-rays. It can be used in combination with a contrast medium, which is injected through the vein, for better evaluation.

The imaging of a hemangioma of the liver is impressive because it consists of very fine blood vessel clusters which accumulate with the contrast medium. A computed tomography examination is often initiated only after a mass in the liver has been detected by ultrasound. This can then provide certainty of the benignity of the findings obtained.

Magnetic resonance imaging, or magnetic resonance imaging, is a low-radiation examination medium that provides good resolution for tomographic imaging of soft tissue structures. As in CT, a contrast medium can also be used in MRI to confirm the diagnosis.The hemangioma is enriched with the contrast medium and can thus be shown in its positional relationship to other structures in the liver. Sonography of the upper abdomen also shows the liver in slices and is often the first step in the diagnosis.

The ultrasound probe is moved fan-like over the different positions for liver evaluation. If a hemangioma or other unclear space requirement is suspected, a contrast medium CT or MRI examination should be carried out subsequently to confirm the diagnosis. How well a hemangioma can be distinguished from a metastasis in the liver depends on the examination method.

Usually the examination begins with a palpation of the liver, in both cases an enlargement of the organ may be detected. An ultrasound of the liver and abdomen is then performed. In this examination the hemangioma appears as a light structure, whereas the metastasis can appear as either a dark or a light structure and is particularly sharply demarcated from the surroundings at the edge. In CT or MRI, contrast agent accumulates very quickly at the edge of the hemangioma, and a little later it reaches the center. The liver metastases, on the other hand, generally absorb hardly any contrast agent and therefore do not stand out particularly brightly from the surroundings in imaging.