Natural history of hepatic hemangiomas as a guide for surgical indication
| Autor: | Bahaa Elwakeel, Mohamed Mogahed, Ashraf Anas Zytoon, Wessam Abdellatif, Bassem Essa, Nashwa S. Ghanem |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Natural history lcsh:Surgery Age and sex Asymptomatic Hemangioma Hepatic hemangiomas 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Outpatient clinic lcsh:RC799-869 General Environmental Science medicine.diagnostic_test business.industry lcsh:RD1-811 Hepatology medicine.disease Surgical indication Surgery 030220 oncology & carcinogenesis Abdominal ultrasonography Liver Hemangioma General Earth and Planetary Sciences lcsh:Diseases of the digestive system. Gastroenterology 030211 gastroenterology & hepatology medicine.symptom business |
| Zdroj: | Egyptian Liver Journal, Vol 10, Iss 1, Pp 1-7 (2020) |
| ISSN: | 2090-6226 |
| DOI: | 10.1186/s43066-020-00065-5 |
| Popis: | Background Generally, hemangiomas are asymptomatic and most lesions are incidentally diagnosed on abdominal ultrasonography. The indications for surgery are still debated mainly due to limited data about the natural history of hepatic hemangiomas. The aim of this study is to investigate the natural history of hepatic hemangiomas, the effects of age and sex on their growth, and their tendency to increase in size or causing symptoms or complications as a guide for surgical indication. In this current study, combined retrospective and prospective analysis was conducted on 186 Egyptian adult patients having 244 hepatic hemangiomas who attended to the outpatient clinics. Follow-up was performed to observe the accurate site, size, number, rate of growth of the lesions, and their tendency to cause symptoms or complications. Results Ninety-one percent of patients were asymptomatic and 9% were symptomatic. During follow-up, 48% of patients showed an increase in tumor diameter, 22% decreased, and 30% were stable. The growth rate at 18–45-year group showed an increasing trend that was higher in females; it was 3.3 ± 2 mm/year for males and 3.9 ± 1.8 mm/year for females. At ˃ 45 year group, the female patients showed a decreasing trend (− 2.1 ± 1.1 mm/year) while in males showed an increasing trend that was slower than in 18–45-year group (2.6 ± 1.7 mm/year). Conclusion Growth pattern of liver hemangiomas is affected by age and sex. The majority of hemangiomas are asymptomatic and complications are rare. Hemangioma size alone is not an indication for surgery in asymptomatic patients. Surgical indications are limited to patients with severe symptoms, complications, or suspicious lesions. Most hemangiomas can be managed conservatively even giant hemangiomas. |
| Databáze: | OpenAIRE |
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