Transcatheter arterial embolization in the treatment of symptomatic cavernous hemangiomas of the liver: a prospective study

Background. This prospective study evaluated the clinical and radiologic re sults of transcatheter arterial embolization (TAE) for the treatment of sym ptomatic cavernous hemangiomas of the liver. The technique, its complicatio ns, and effectiveness also were analyzed. Methods. Eight patients (five male, three female; mean age SD = 47.75 +/- 8 .59 years) with symptomatic cavernous hemangiomas of the liver were treated by TAE with polyvinyl alcohol particles or gelfoam and steel coils (single session) followed by supportive treatment. Tumor characterization (includi ng the extent and number of lesions.) was done on triple-phase helical comp uted tomography or gadolinium-enhanced dynamic magnetic resonance imaging. Results: The lesions were located in the right lobe in five patients, left lobe in one, and both lobes in two. The largest diameter of the lesions was 6-18 cm (9.28 +/- 5.13 cm). The treatment response was assessed on follow- up ultrasound and color Doppler and/or contrast-enhanced helical computed t omography. There were no treatment-related deaths and morbidity was minimal . Embolization was the only method of treatment in seven patients; however, one patient had surgery after TAE because the symptoms were only partly re lieved. Indications for embolization were abdominal pain (eight patients), rapid tumor enlargement (four of eight), and recurrent jaundice (one of eig ht). Symptomatic improvement was documented in all patients after embolizat ion. Symptoms did not worsen in any patient. The mean size of the, tumor di d not show any statistically significant change on follow-up radiologic exa minations. However, in one patient, the tumor significantly regressed in si ze after embolization. Conclusion: TAE of hepatic cavernous hemangioma is a useful procedure in th e therapy of symptomatic hemangiomas.