Skip to main content

Advertisement

Log in

Hepatic Hemangioma Treatment Using Microwave Coagulation Therapy—a Systematic Review

  • Review Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Hepatic hemangiomas (HH) are the most common benign liver tumors, with a prevalence ranging from 5 to 7.35% of all benign tumors of the liver. Most lesions occur to the fifth and sixth decades of life more frequently in females (female/male ratio = 5:1). Hepatic hemangiomas are composed of blood-filled cavities lined by a single layer of endothelial cells, fed by the hepatic artery. Hepatic hemangiomas are composed of blood-filled cavities lined by a single layer of endothelial cells, fed by the hepatic artery. The exact etiology of hepatic hemangiomas still is unclear though the genetic predisposition and estrogen in stimulating and/or contraceptive use have been proposed. A majority of hepatic hemangiomas are often asymptomatic and discovered incidentally. It is a slow-growing, so medical/surgical intervention is often not needed. However, the so-called giant cavernous hemangiomas (GCH) (greater than 5 cm in diameter) will usually develop symptoms and complications, which pose a higher risk of rupture that a radical intervention needs to be considered. Nowadays, hepatic hemangiomas therapy included surgical resection, intervention embolization, radio frequency ablation, microwave ablation, and drug therapy. There have been existing heated debates on the treatment strategies of hepatic hemangiomas for a long time because of the researchers lacked the evidence-based medical evidence data to analyze those treatment methods respectively. The present study is a comprehensive review of various treatments specially use of microwave ablation in large and symptomatic hepatic hemangiomas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Beatty JS, Mitchell JW, Holsten SB, Ferdinand CH (2013) Traumatic rupture of a previously undiagnosed giant hepatic hemangioma. Am Surg 79(9):e314–e315

    PubMed  Google Scholar 

  2. Hasan HY, Hinshaw JL, Borman EJ, Gegios A, Leverson G, Winslow ER (2014) Assessing normal growth of hepatic hemangiomas during long-term follow-up. JAMA Surg 149(12):1266–1271

    PubMed  Google Scholar 

  3. Ji J, Gao J, Zhao L, Tu J, Song J, Sun W (2016) Computed tomography-guided radiofrequency ablation following transcatheter arterial embolization in treatment of large hepatic hemangiomas. Medicine 95(15):e3402

    PubMed  PubMed Central  Google Scholar 

  4. Miura JT, Amini A, Schmocker R, Nichols S, Sukato D, Winslow ER, Spolverato G, Ejaz A, Squires MH, Kooby DA, Maithel SK, Li A, Wu MC, Sarmiento JM, Bloomston M, Christians KK, Johnston FM, Tsai S, Turaga KK, Tsung A, Pawlik TM, Gamblin TC (2014) Surgical management of hepatic hemangiomas: a multi-institutional experience. HPB (Oxford) 16(10):924–928

    Google Scholar 

  5. Bajenaru N, Balaban V, Savulescu F et al (2015) Hepatic hemangioma-review. J Med Life 8(Spec Issue):4–11

    PubMed  PubMed Central  Google Scholar 

  6. Leon M, Chavez L, Surani S (2020) Hepatic hemangioma: what internists need to know. World J Gastroenterol 26(1):11–20

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Prodromidou A, Machairas N, Garoufalia Z, Kostakis ID, Tsaparas P, Paspala A, Stamopoulos P, Sotiropoulos GC (2019) Liver transplantation for giant hepatic hemangioma: a systematic review. Transplant Proc 51(2):440–442

    CAS  PubMed  Google Scholar 

  8. Gao J, Ding X, Ke S, Xin Z, Ning C, Sha Q, Sun W (2014) Radiofrequency ablation in the treatment of large hepatic hemangiomas: a comparison of multitined and internally cooled electrodes. J Clin Gastroenterol 48(6):540–547

    CAS  PubMed  Google Scholar 

  9. Gao J, Kong J, Ding XM, Ke S, Niu HG, Xin ZH, Ning CM, Guo SG, Li XL, Zhang L, Dong YH, Sun WB (2015) Laparoscopic vs computerized tomography-guided radiofrequency ablation for large hepatic hemangiomas abutting the diaphragm. World J Gastroenterol 21(19):5941–5949

    PubMed  PubMed Central  Google Scholar 

  10. Liu L, Li N (2014) Feasibility and advantages of large liver hemangioma treated with laparoscopic microwave ablation. Hepatogastroenterology 61(132):1068–1073

    PubMed  Google Scholar 

  11. Tang XY, Wang Z, Wang T, Cui D, Zhai B (2015) Efficacy, safety and feasibility of ultrasound-guided percutaneous microwave ablation for large hepatic hemangioma. J Dig Dis 16(9):525–530

    PubMed  Google Scholar 

  12. Boutros C, Somasundar P, Garrean S, Saied A, Espat NJ (2010) Microwave coagulation therapy for hepatic tumors: review of the literature and critical analysis. Surg Oncol 19(1):e22–e32

    CAS  PubMed  Google Scholar 

  13. North DA, Groeschl RT, Sindram D, Martinie JB, Iannitti DA, Bloomston M, Schmidt C, Rilling WS, Gamblin TC, Martin RCG (2014) Microwave ablation for hepatic malignancies: a call for standard reporting and outcomes. Am J Surg 208(2):284–294

    PubMed  Google Scholar 

  14. Abdelaziz A, Elbaz T, Shousha HI, Mahmoud S, Ibrahim M, Abdelmaksoud A, Nabeel M (2014) Efficacy and survival analysis of percutaneous radiofrequency versus microwave ablation for hepatocellular carcinoma: an Egyptian multidisciplinary clinic experience. Surg Endosc 28(12):3429–3434

    PubMed  Google Scholar 

  15. Cillo U, Noaro G, Vitale A, Neri D, D'Amico F, Gringeri E, Farinati F, Vincenzi V, Vigo M, Zanus G, HePaTIC Study Group (2014) Laparoscopic microwave ablation in patients with hepatocellular carcinoma: a prospective cohort study. HPB (Oxford) 16(11):979–986

    Google Scholar 

  16. Gruttadauria S, Pagano D, Tropea A, Cintorino D, Castellana L, Bonsignore P, Ricotta C, Piccolo G, Vizzini G, Luca A (2016) Laparoscopic approach for thermoablation microwave in the treatment of hepatocellular carcinoma: a single center experience. J Laparoendosc Adv Surg Tech A 26(10):808–811

    PubMed  Google Scholar 

  17. Na BG, Kim JM, Oh DK, Lee KW, Kang TW, Choi GS, Lee MW, Kwon CHD, Lim HC, Joh JW (2017) Clinical outcomes of laparoscopic radiofrequency ablation of single primary or recurrent hepatocellular carcinoma (</=3 cm). Ann Surg Treat Res 92(5):355–360

    PubMed  PubMed Central  Google Scholar 

  18. Cillo U, Vitale A, Dupuis D, Corso S, Neri D, D'Amico F, Gringeri E, Farinati F, Vincenzi V, Zanus G (2013) Laparoscopic ablation of hepatocellular carcinoma in cirrhotic patients unsuitable for liver resection or percutaneous treatment: a cohort study. PLoS One 8(2):e57249

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Bailey J, Di Carlo S, Blackwell J et al (2016) Same day arterial embolisation followed by hepatic resection for treatment of giant haemangioma. BMJ Case Rep 2016:bcr2015213259

    PubMed  PubMed Central  Google Scholar 

  20. Li Y, Jia Y, Li S, Wang W, Wang Z, Wang Y, Liu B, Wang W, Chang H, Li Z (2015) Transarterial chemoembolization of giant liver haemangioma: a multi-center study with 836 cases. Cell Biochem Biophys 73(2):469–472

    CAS  PubMed  Google Scholar 

  21. Ziemlewicz TJ, Wells SA, Lubner MA, Musat AI, Hinshaw JL, Cohn AR, Lee FT Jr (2014) Microwave ablation of giant hepatic cavernous hemangiomas. Cardiovasc Intervent Radiol 37(5):1299–1305

    PubMed  Google Scholar 

  22. Efthimiadis C, Ioannidis A, Grigoriou M et al (2017) Robotic right segmental hepatectomy for the treatment of a giant hepatic hemangioma-a case report. J Surg Case Rep 2017(6):rjx118

    PubMed  PubMed Central  Google Scholar 

  23. Lerner SM, Hiatt JR, Salamandra J, Chen PW, Farmer DG, Ghobrial RM, Busuttil RW (2004) Giant cavernous liver hemangiomas: effect of operative approach on outcome. Arch Surg 139(8):818–821

    PubMed  Google Scholar 

  24. Clarke DL, Currie EJ, Madhavan KK, Parks RW, Garden OJ (2004) Hepatic resection for benign non-cystic liver lesions. HPB (Oxford) 6(2):115–119

    CAS  Google Scholar 

  25. Hoekstra LT, Bieze M, Erdogan D, Roelofs JJTH, Beuers UHW, Gulik TM (2013) Management of giant liver hemangiomas: an update. Expert Rev Gastroenterol Hepatol 7(3):263–238

    CAS  PubMed  Google Scholar 

  26. Toro A, Mahfouz AE, Ardiri A, Malaguarnera M, Malaguarnera G, Loria F, Bertino G, Carlo ID (2014) What is changing in indications and treatment of hepatic hemangiomas. A review. Ann Hepatol 13(4):327–339

    PubMed  Google Scholar 

  27. Zhang W, Huang ZY, Ke CS, Wu C, Zhang ZW, Zhang BX, Chen YF, Zhang WG, Zhu P, Chen XP (2015) Surgical treatment of giant liver hemangioma larger than 10 cm: a single center's experience with 86 patients. Medicine (Baltimore) 94(34):e1420

    Google Scholar 

  28. Hajong R (2013) Giant hepatic hemangioma. Indian J Gastroenterol 32(5):352

    PubMed  Google Scholar 

  29. ChandraBose K, Ramanujam A, Muthu Y (2015) Enucleation of a giant hemangioma of liver: old school revisited. Case Rep Surg 2015:234767

    PubMed  PubMed Central  Google Scholar 

  30. Wu XF, Bai XM (2020) Differentiation of atypical hepatic hemangioma from liver metastases: diagnostic performance of a novel type of color contrast enhanced ultrasound. World J Gastroenterol 26(9):960–972

    PubMed  PubMed Central  Google Scholar 

  31. Zhao W, Guo X, Dong J (2015) Spontaneous rupture of hepatic hemangioma: a case report and literature review. Int J Clin Exp Pathol 8(10):13426–13428

    PubMed  PubMed Central  Google Scholar 

  32. Schnelldorfer T, Ware AL, Smoot R, Schleck CD, Harmsen WS, Nagorney DM (2010) Management of giant hemangioma of the liver: resection versus observation. J Am Coll Surg 211(6):724–730

    PubMed  Google Scholar 

  33. Lerut J, Iesari S (2018) Vascular tumours of the liver: a particular story. Transl Gastroenterol Hepatol 3:62

    PubMed  PubMed Central  Google Scholar 

  34. Mahajan D, Miller C, Hirose K, McCullough A, Yerian L (2008) Incidental reduction in the size of liver hemangioma following use of VEGF inhibitor bevacizumab. J Hepatol 49(5):867–870

    CAS  PubMed  Google Scholar 

  35. Tiwari P, Mahajan V, Muhrerkar K, Sunil BJ, Ramakrishnan A, Ganesan T (2018) Effectiveness of Sorafenib in hepatic hemangioma. J Glob Oncol 4:1–4

    PubMed  Google Scholar 

  36. Dumlu EG, Abbasoglu O, Hamaloglu E (2014) Is surgical treatment of liver hemangiomas effective for pain relief? Chirurgia (Bucur) 109(5):634–638

    CAS  Google Scholar 

  37. Moctezuma-Velázquez C, López-Arce G, Martínez-Rodríguez LA, Escalona-Huerta C, Chapa-Ibargüengoitia M, Torre A (2014) Giant hepatic hemangioma versus conventional hepatic hemangioma: clinical findings, risk factors, and management. Rev Gastroenterol Mex 79(4):229–237

    PubMed  Google Scholar 

  38. Tabuse K (1979) A new operative procedure of hepatic surgery using a microwave tissue coagulator. Nihon Geka Hokan 48(2):160–172

    CAS  PubMed  Google Scholar 

  39. Tabuse K (1998) Basic knowledge of a microwave tissue coagulator and its clinical applications. J Hepato-Biliary-Pancreat Surg 5(2):165–172

    CAS  Google Scholar 

  40. Seki T, Wakabayashi M, Nakagawa T, Itho T, Shiro T, Kunieda K, Sato M, Uchiyama S, Inoue K (1994) Ultrasonically guided percutaneous microwave coagulation therapy for small hepatocellular carcinoma. Cancer 74(3):817–825

    CAS  PubMed  Google Scholar 

  41. Iida H, Aihara T, Ikuta S et al (2013) A comparative study of therapeutic effect between laparoscopic microwave coagulation and laparoscopic radiofrequency ablation. Hepatogastroenterology 60(124):662–665

    PubMed  Google Scholar 

  42. Li XH, Wang YF, Sun GM (2015) Transcatheter arterial chemoembolization combined with microwave coagulation therapy and the perioperative care for patients with hepatocellular carcinoma. J BUON 20(4):1037–1041

    PubMed  Google Scholar 

  43. Zhuang X, Wang Q, Wang N, Hou X, Zhang J, Chi H (2016) Effects of combining transarterial chemoembolization with percutaneous microwave coagulation therapy for hepatocellular carcinoma abutting the diaphragm. Minim Invasive Ther Allied Technol 25(2):107–112

    PubMed  Google Scholar 

  44. Bala MM, Riemsma RP, Wolff R et al (2013) Microwave coagulation for liver metastases. Cochrane Database Syst Rev 10:CD010163

    Google Scholar 

  45. Wang S, Gao J, Yang M, Ke S, Ding X, Kong J, Xu L, Sun W (2017) Intratumoral coagulation by radiofrequency ablation facilitated the laparoscopic resection of giant hepatic hemangioma: a surgical technique report of two cases. Oncotarget 8(31):52006–52011

    PubMed  PubMed Central  Google Scholar 

  46. Eisele RM, DeneckeT, Glanemann M, et al. Minimal-invasive microwave coagulation therapy for liver tumours: laparoscopic and percutaneous access. Zentralbl Chir, 2014, 139(2): 235–243

  47. Zhang EL, Yang F, Wu ZB, Yue CS, He TY, Li KY, Xiao ZY, Xiong M, Chen XP, Huang ZY (2016) Therapeutic efficacy of percutaneous microwave coagulation versus liver resection for single hepatocellular carcinoma </=3 cm with child-Pugh a cirrhosis. Eur J Surg Oncol 42(5):690–607

    PubMed  Google Scholar 

  48. van Tilborg AAJM, Dresselaars HF, Scheffer HJ, Nielsen K, Sietses C, van den Tol PM, Meijerink MR (2016) RF ablation of Giant Hemangiomas inducing acute renal failure: a report of two cases. Cardiovasc Intervent Radiol 39(11):1644–1648

    PubMed  PubMed Central  Google Scholar 

  49. Schiffl H (2015) Sodium bicarbonate infusion for prevention of acute kidney injury: no evidence for superior benefit, but risk for harm? Int Urol Nephrol 47(2):321–326

    CAS  PubMed  Google Scholar 

  50. Tamaki K, Shimizu I, Oshio A, Fukuno H, Inoue H, Tsutsui A, Shibata H, Sano N, Ito S (2004) Influence of large intrahepatic blood vessels on the gross and histological characteristics of lesions produced by radiofrequency ablation in a pig liver model. Liver Int 24(6):696–701

    PubMed  Google Scholar 

  51. Vyas S, Ahuja CK, Yadav TD, Khandelwal N (2012) Emergency ultrasound-guided percutaneous embolization of post-traumatic bleeding hepatic artery pseudoaneurysms. Minim Invasive Ther Allied Technol 21(5):372–376

    PubMed  Google Scholar 

  52. Sharpe EE 3rd, Dodd GD 3rd. (2012) Percutaneous radiofrequency ablation of symptomatic giant hepatic cavernous hemangiomas: report of two cases and review of literature. J Vasc Interv Radiol 23(7):971–975

    PubMed  Google Scholar 

  53. Gao J, Ji JS, Ding XM, Ke S, Xin ZH, Ning CM, Guo SG, Li XL, Dong YH, Sun WB (2016) Laparoscopic radiofrequency ablation for large subcapsular hepatic Hemangiomas: technical and clinical outcomes. PLoS One 11(2):e0149755

    PubMed  PubMed Central  Google Scholar 

  54. Gao J, Ke S, Ding XM, Zhou YM, Qian XJ, Sun WB (2013) Radiofrequency ablation for large hepatic hemangiomas: initial experience and lessons. Surgery 153(1):78–85

    PubMed  Google Scholar 

  55. Zou H, Yan J, Wu YX, Ou X, Li XW, Xia F, Ma KS, Bie P (2012) The new technology of enhanced radiofrequency ablation is safe and effective for treating giant hepatic hemangioma. Zhonghua Gan Zang Bing Za Zhi 20(4):261–265

    PubMed  Google Scholar 

  56. Chen L, Zhang L, Tian M et al (2019) Safety and effective of laparoscopic microwave ablation for giant hepatic hemangioma: a retrospective cohort study. Ann Med Surg (Lond) 39:29–35

    Google Scholar 

  57. Liu F, Yu X, Liang P, Cheng Z, Han Z, Yu J (2018) Ultrasonography-guided percutaneous microwave ablation for large hepatic cavernous haemangiomas. Int J Hyperth 34(7):1061–1066

    Google Scholar 

  58. Wang Z, Tang X, Qi X, Shi Y, Chi J, Li P, Zhai B (2018) Feasibility, safety, and efficacy of ultrasound-guided percutaneous microwave ablation for giant hepatic hemangioma. Int J Hyperth 35(1):246–252

    Google Scholar 

  59. Tang X, Ding M, Lu B et al (2019) Outcomes of ultrasound-guided percutaneous microwave ablation versus surgical resection for symptomatic large hepatic hemangiomas. Int J Hyperth 36(1):632–639 Experience and lessons. Surgery, 2013, 153(1): 78–85

    Google Scholar 

Download references

Funding

This research was supported by the scientific research and technology development plan of Nanning (20193100, Z20191065, Z20190446).

Author information

Authors and Affiliations

Authors

Contributions

Zhi Zhang and Jia-zhi Li contributed equally to this manuscript, literature search, and writing original draft preparation and Hong-Mian Li in reviewing and editing. All authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Hong-Mian Li.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, Z., Li, Jz. & Li, HM. Hepatic Hemangioma Treatment Using Microwave Coagulation Therapy—a Systematic Review. Indian J Surg 83, 9–16 (2021). https://doi.org/10.1007/s12262-020-02372-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-020-02372-y

Keywords

Navigation