Transcatheter Arterial Embolization Alone for Giant Hepatic Hemangioma

PLoS One. 2015 Aug 19;10(8):e0135158. doi: 10.1371/journal.pone.0135158. eCollection 2015.

Abstract

Giant hepatic hemangioma is a benign liver condition that may be treated using surgery. We studied the digital subtraction angiographic (DSA) characteristics of giant hepatic hemangioma, and the effectiveness of transcatheter arterial embolization (TAE) alone for its treatment. This was a retrospective study of 27 patients diagnosed with giant hepatic hemangioma and treated with TAE alone (using lipiodol mixed with pingyangmycin) at the Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University, between January 2010 and March 2013. The feeding arteries were identified using DSA. All patients were followed up for between three weeks and 12 months. Changes in tumor diameter and symptoms were observed. The 27 patients included had giant hepatic hemangiomas ranging from 5.3 to 24.5 cm (mean, 11.24±5.08 cm) in the right (n = 13), left (n = 1) or both (n = 13) lobes. Preoperative hepatic angiography showed multiple abnormal vascular lakes in the early phase, known as the "early leaving but late returning, hanging nut on a twig" sign. On the day after TAE, hepatic transaminase levels were increased (ALT: 22.69±17.95 to 94.88±210.32 U/L; ALT: 24.00±12.37 to 99.70±211.54 U/L; both P<0.05), but not total bilirubin. Six patients complained of abdominal pain, and 12 experienced transient fever. In the months after TAE, tumor size decreased (baseline: 11.24±5.08; 3 months: 8.95±4.33; 6 months: 7.60±3.90 cm; P<0.05), and the patients' condition improved. These results indicated that TAE was effective and safe for treating giant hepatic hemangioma. TAE may be a useful alternative to surgery for the treatment of hepatic hemangioma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiography, Digital Subtraction
  • Bleomycin / analogs & derivatives
  • Bleomycin / therapeutic use
  • Embolization, Therapeutic / methods*
  • Ethiodized Oil / therapeutic use
  • Female
  • Hemangioma, Cavernous / diagnostic imaging
  • Hemangioma, Cavernous / therapy*
  • Humans
  • Liver / blood supply
  • Liver / diagnostic imaging
  • Liver / pathology*
  • Male
  • Retrospective Studies
  • Tomography, X-Ray Computed

Substances

  • Bleomycin
  • bleomycetin
  • Ethiodized Oil

Grants and funding

This study was supported by the National Clinical Key Subject Construction Project (General Surgery), the National Natural Science Foundation of China (No. 81371658), Zhejiang Provincial Natural Science Foundation of China (No. LQ14H120001 and NO.Y2110183), and Medical Health Fund of Zhejiang Province (No. 2013KYB097).