Multiple Hepatic Hemangiomas

Case Courtesy of​

Dr / Hossam Eldeen Fouad

Radiologist at Kuwait Cancer Control Center, Kuwait, MSc., FEBR.

Case Images
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Multiple hepatic hemangiomas (1)
Multiple hepatic hemangiomas (2)
Multiple hepatic hemangiomas (3)
Multiple hepatic hemangiomas (4)
Multiple hepatic hemangiomas (5)
Multiple hepatic hemangiomas (6)
Multiple hepatic hemangiomas (7)
Multiple hepatic hemangiomas (8)
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Gastrointestinal/oncology radiology
Multiple hepatic hemangiomas (some are giant hemangiomas)
  • A case of multiple myeloma with altered liver function tests.
  • Ultrasound revealed multiple hepatic focal lesions.

CT findings:

  • Quadriphasic CT study (A = pre-contrast, B = Arterial phase, C = Portal phase, & D = Delayed phase) revealed multiple variable sized hypodense hepatic focal lesions scattered in both lobes, largest measures approximately 6.3 x 8.5 cm, all showing peripheral nodular enhancement in the arterial phase, with continuous centripetal enhancement in the portal and delayed phases.
  • Some of the smaller lesions became more homogeneous with the liver parenchyma in the delayed phase.
  • Giant hemangiomas may demonstrate similar findings to their smaller relatives, and follows aortic attenuation.
  • Contrast filling may be slow and the central portions may never demonstrate complete contrast fill in.
  • In such case when the diagnosis is certain, no need for further MRI assessment.
  • More delayed images may be helpful.

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