Table 1.
Three different types of hepatic hemangiomas.
Parameter | Congenital hepatic hemangioma | Multifocal infantile hepatic hemangioma | Diffuse infantile hepatic hemangioma |
---|---|---|---|
Age at onset | Prenatal | Postnatal | Postnatal |
Growth pattens | Grow antenatally and fully formed at birth | Growth in the first weeks or months after birth | Rapid growth in the first weeks or months after birth |
Symptoms and complications | Rarely associated with cutaneous IH. Most cases are asymptomatic. Some cases have mild anemia or thrombocytopenia. Few cases with high-output cardiac failure due to macrovascular shunting. Do not cause hypothyroidism | Frequently associated with cutaneous IH. Many cases are asymptomatic. Some cases with moderate hypothyroidism, high-output cardiac failure secondary to macrovascular shunting | Frequently associated with cutaneous IH. Almost all cases are symptomatic, with abdominal compartment syndrome, cardiac failure, and severe hypothyroidism |
Image findings on MRI | A solitary, well-defined, spherical lesion; usually hypointense to liver on T1-weight image and hyperintense on T2-weight image; centripetal enhancement with gadolinium | Multiple homogeneous enhanced spherical lesions with intervening areas of normal hepatic parenchyma; hypointense to liver on T1-weight image and hyperintense on T2-weight image | Innumerable lesions nearly involve the whole liver |
Pathological features | Negative for glucose transporter-1 | Positive for glucose transporter-1 | Positive for glucose transporter-1 |
Management | Observation for asymptomatic patients; embolization or surgery for severe macrovascular shunting | Observation for asymptomatic patients; embolization or surgery for severe macrovascular shunting; propranolol, steroid, a combination of medical treatment; thyroid hormone replacement for cases with hypothyroidism; liver transplantation | Propranolol, steroid, or a combination of medical treatment; thyroid hormone replacement for cases with hypothyroidism; embolization for sever macrovascular shunting; liver transplantation |