Hemangioma of the liver is a benign (noncancerous) mass that grows in the liver and is made up of blood vessels that are tangled and contain blood and is less than 4 cm (1.5 inches) in size. Sometimes they can be larger than this, or there may be several present in the liver.

Most people who have a liver hemangioma are totally unaware of it as they never experience any signs or symptoms. It is usually discovered incidentally during a test or scan for some other problem. It is a safe tumor to have because there is no evidence that it can lead to liver cancer if left untreated.

In a minority of patients with a liver hemangioma some symptoms may occur and include:
•    Nausea or vomiting
•    Discomfort or pressure in the upper right abdomen
•    Feeling full after eating
•    Lack of appetite

Causes of hemangioma in the liver

It is believed that liver hemangioma is congenital, which means that you are born with it. Women who have been pregnant are more likely to have a liver hemangioma than women who have never been pregnant. Menopausal women who have been on hormone replacement therapy (HRT) or women who have been on the oral contraceptive pill for several years are more likely to develop a liver hemangioma than women who never used any hormones. Thus, it is thought that the hormone estrogen, found in hormone replacement therapy (HRT) or the oral contraceptive pill and during pregnancy, plays a role in the development and growth of liver hemangiomas.

Women who have a liver hemangioma have a risk of complications if they become pregnant. The high levels of estrogen made during pregnancy may cause some liver hemangiomas to grow larger and this can cause symptoms, which may need treatment.

Just because you have a liver hemangioma does not mean it is too dangerous to become pregnant, but it is important to discuss any risks with your doctor and to take extra care of your liver during pregnancy.

Treatment

In most people, liver hemangioma will never grow and never cause any medical or health problems. But in a very small minority of people, the liver hemangioma will grow and require treatment.

If your liver hemangioma is small and doesn’t cause any signs or symptoms, you do not need any medical treatment. In the vast majority of cases it will never grow any larger and will never cause health problems. It is a good idea to have a bi-annual liver scan to check the hemangiona.

If a liver hemangioma grows large enough to cause pressure on organs or tissues near your liver it can cause symptoms and may require treatment.

If you have a liver hemangioma it is safer to avoid oral contraceptive pills that contain estrogen and there are many new estrogen-free alternative contraceptives available today. Also, avoid types of HRT that contain oral estrogens and use creams containing the safe type of estrogen called estriol.

Treatment options may include:

• Surgery. If the hemangioma can be easily separated from the liver, surgery to remove the tumor may be the best solution. In some cases, a portion of the liver along with the hemangioma is removed.
• Procedures to block the flow of blood to the hemangioma. The blood supply may be blocked through the main artery that supplies the hemangioma and this can be done by tying off the artery (artery ligation) or injecting medication into the artery (arterial embolization). Without a blood supply, the hemangioma may stop growing or shrink. The healthy liver tissue is not damaged by these treatments because it can draw blood from other nearby blood vessels.
• Liver transplant surgery. In very rare situations, if you have a very large hemangioma or multiple hemangiomas that can’t be treated by other means, your doctor may recommend surgery to remove your liver and replace it with a liver from a donor.

Conclusion

Liver disease is serious and requires treatment and regular monitoring by a liver specialist.

A liver specialist is known as a hepatologist and you need to be referred by your family doctor or general practitioner. Over nearly 40 years of practicing medicine, I have seen many patients develop severe liver disease, which sadly could have been prevented by early detection and early referral to a hepatologist. There needs to be more awareness of liver disease so that patients can be treated early so that we can prevent cirrhosis, liver failure and liver cancer. Make sure you have your liver function checked annually with a blood test.

I have presented my ideas on how to help those with liver diseases using nutritional medicine, which I have been using for many years with good success rates. However, my recommendations do not replace the care of your own doctor and you should remain under the care of your own doctor whilst using nutritional therapies.

If you have any questions you may contact my naturopath, Christine, on 623 334 3232 or email us at support@liverdoctor.com

The above statements have not been evaluated by the FDA and are not intended to diagnose, treat or cure any disease.