PMC6710544_01
Contrast-enhanced-MRI showing a 16.7-cm hepatic hemangioma in the right lobe (A-C). Two months after laparoscopic RF ablation, contrast-enhanced-CT revealed that only one-third of the tumor was ablated (red arrow), and the ablated tumor had not shrunk (D-F). Tumor resection was performed by intratumoral coagulation using RF ablation (G). The large hemangioma was removed, and the left lobe of liver was left. The white arrow indicates the inferior vena cava (H). Macroscopic appearance of the tumor. The tumor was composed of solid grey-white masses indicating sclerosing hemangiomas and dark red sponge-like masses indicating cavernous hemangiomas (I and J). The tumor mainly comprised hyalinized tissue and collagen fibers (left) with thin-walled and variably cavernous vascular channels lined by endothelial cells (right) on sections (hematoxylin and eosin staining, H&E, x40) (K). A higher magnification of the hepatic sclerosing hemangioma showed abundant hyalinized tissue and collagen fibers with sporadic vascular spaces (H&E, x100) (L). Postoperative contrast-enhanced CT follow-up confirmed that the hemangioma was completely dissected without any residual tissue one month after the surgery (M-O).
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Contrast-enhanced MRI showed a large hepatic cavernous hemangioma in the right lobe (16.7x15.9 cm) (Figure 1A-C). Two months post-surgery, contrast-enhanced computed tomography (CT) confirmed that only one-third of the tumor was ablated, and the ablated tumor tissue had not decreased in size (Figure 1D-F). Because the minimally invasive therapy with RF ablation had failed, RF-assisted right hepatectomy was performed (Figure 1G-H). On pathological examination, the resected liver tumor was found to be composed of solid grey-white masses, which indicated sclerosing hemangiomas (30%), and dark red sponge-like masses, which indicated cavernous hemangiomas (70%) (Figure 1I and J). Histopathological evaluation of tissue sections revealed that the tumor mainly comprised hyalinized tissue and collagen fibers with thin-walled and variably cavernous vascular channels that were lined by endothelial cells (Figure 1K and L). Postoperative contrast-enhanced CT follow-up confirmed that the hemangioma was completely dissected without any residual tissue one month after the surgery (Figure 1M-O).