Abstract

Cavernous hemangioma is the most common begin hepatic tumor. But unfortunately, differentiation with hepatocellular carcinoma is quite difficult especially in patients with an underlying liver cirrhosis. A 49-year-old man with alcoholic liver cirrhosis was admitted for evaluation of a hepatic lesion found during a routine follow up. There was no abnormal findings in the physical examination. The HBs Ag, anit-HBs Ab, anti-HCV Ab were all negative, with an AFP level of 3.28 ng/mL. The dynamic CT scan revealed a 2 cm sized mass with a heterogenously enhancement on arterial phase at S6, which became isoattenuation on portal phase and delayed phase. Angiographic study showed a hypervascular mass with an arteriovenous shunt and in the lipiodol CT, a 2 cm sized mass with a lipiodol uptake was detected in the same area. Segmentectomy of S6 was performed under the impression of HCC. The cut surface of the mass had a sponge like feature, and was pathologically defined as cavernous hemangioma. From out experience, we recommentd careful assessment and differentiation of hemangioma and hepatocellular carcinoma to avoid misdiagnosis and MRI might be helpful in this case.

• Keywords: Hepatocellular carcinoma;Mimicking;Cavernous hemangioma