Hepatic Infantile Hemangioma

  • Etiology: congenital vascular tumor
  • 3 subtypes
  • Multifocal: clinically asymptomatic with skin hemangiomas, GLUT1(+), small without necrosis, proliferation then involution
  • Focal: clinically have congestive heart failure, GLUT1(-), large with necrosis, involute by 1 year
  • Diffuse: clinically have congestive heart failure + hypothyroidism + compartment syndrome, GLUT1(+), hepatomegaly with multiple masses, complicated clinical course
  • CT: can have fine / granular calcification, arterial phase shows peripheral nodular enhancement of mass that enhances more than the liver with centripedal fill in during delayed phase
  • Clinical: rarely has elevated AFP (15%), 30% diagnosed in first month / 90% diagnosed in first 6 months

Radiology Cases of Hepatic Infantile Hemangioma

MRI of liver hemangioma
Coronal T1 weighted MRI without (left) and with (right) contrast of the abdomen shows a round, well-circumscribed lesion in the right lobe of the liver that has ring enhancement and that was seen to fill in on delayed images.
CT of liver hemangioma
Axial CT with contrast of the abdomen in the arterial phase (upper left) and then 1, 7 and 15 minutes later (lower right) shows a large liver mass that has an enhancing rim and a low density center which slowly filled in on delayed images.