Congenital hepatic hemangioma
- Etiology: vascular, benign endothelial channels of varying size with fibrosis
- Imaging: solitary, large, heterogenous, big vessels with shunting, broadening peripheral enhancement, not central enhancement, can have calcification
- DDX:
- Complications:
- Treatment:
- Clinical: may have an associated cutaneous lesion, present prenatally or at birth, less common hemangioma (30%), equal male and female prevalence, growth is complete at birth or grows proportionately with the child’s growth, rapidly involuting (RICH) and non-involuting (NICH), RICH tumor regresses by 18-24 months, does not need tissue sampling, heart failure / mild anemia + thrombocytopenia / neonatal AFP levels, GLUT-1 negative
- Note: beware of this diagnosis if seen after first week of life, rising or steadily elevated AFP, increasing size
Infantile hepatic hemangioma
- Etiology: vascular, benign neoplasm of capillaries
- Imaging: focal or multifocal or diffuse, small to moderate, homogenous, +/- vascularity / AV shunting, early peripheral to delayed central enhancement with centripetal fill in
- DDX:
- Complications:
- Treatment: propranolol or steroids
- Clinical: characteristic cutaneous appearance, develops within weeks – months, more common hemangioma (70%), female prevalence (5:1), grows rapidly for approximately 6-12 months followed by slow involution (over 5-9 years), 90% regress by 9 years, GLUT-1 positive
- Note: beware this diagnosis if there are atypical or no cutaneous lesions, a dominant hepatic lesion or other abdominal masses
Radiology Cases of Congenital Hepatic Hemangioma
Pediatric Imaging 