Abstract
A 56-year-old female complaining of macrohematuria was accidentally found to have a liver tumor by ultrasonography. Selective celiac angiography showed a hypervascular hepatic lesion with haphazard marked neovascularity, dilated feeding artery and mottled tumor stain, 90 mm in diameter, in the middle and cranial portion of the liver. On angio-CT, dense accumulation of contrast material near the periphery of the lesion in early contrast scan, accumulation spreading toward the center of the tumor with time, and marked reduction of the low density area in the late scan were recognized. The lesion was diagnosed as hepatoma as a result of the findings on angiography, although hemangioma was strongly suggested by angio-CT.
At laparotomy the tumor was found in the right caudate lobe, and extended medial segmentectomy (caudate, middle and right anterosuperior segments) was performed. The cut surface of the resected specimen was spongy and dark red in color except for a whitish area at the center of the tumor. Histologically it was liver cavernous hemangioma without malignancy. The fact that many abnormal arteries were recognized near the capsul of the tumor reflected the findings of neovascularity on angiography.
We should pay careful attention to differential diagnosis between hepatoma and hemangioma with neovascularity on angiography.
