PMC7509359_01
Contrast-enhanced abdominal CT scan. a Coronal section: giant intraperitoneal hemangioma (yellow arrow) with a vascularized pedicle originating from segment IV (red arrow). b Axial section: shows the pedicle dependent on hepatic IV-B segment, with scarce contrast enhancement and tortuosity like the whirlpool sign (blue arrow).
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A second-opinion review of the CT images, after the intraoperative finding, reports it as a Giant Hepatic Hemangioma (Fig. 1).
Cavernous Hepatic Hemangioma: Exophytic lesion with a vascularized appearance dependent on the liver with a wide pedicle originating from liver segment IV.
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Giant Hepatic Hemangioma: A twisted pedicle originating from hepatic segment IVB is seen.
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IVB and caudally extending to the right iliac fossa. It had undergone torsion on its peduncle (Fig. 3).
Cavernous Hepatic Hemangioma: Proliferation of blood vessels of variable caliber with marked sinusoidal dilation and thinned walls covered by endothelium without atypia, occasionally filled with intraluminal thrombi over a hemorrhagic fibrous stroma.
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Histologic assessment with hematoxylin-eosin staining confirmed a cavernous hepatic hemangioma. (Fig. 4).