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KEY FACTS
Terminology
Imaging
Clinical Issues
TERMINOLOGY
Synonyms
- Not hemangioendothelioma (more aggressive vascular tumor, not typically found in infantile liver)
- Not cavernous hemangioma (venous malformation, not typically found in infantile liver)
Definitions
- Hemangioma: Benign endothelial neoplasm occurring in soft tissues or viscera (especially liver: Most common benign hepatic tumor of infants)
- 70% of 2009 publications used term hemangioma incorrectly
- Congenital hemangioma (CH): Found in perinatal period; does not proliferate beyond birth
- Rapidly involuting (RICH) vs. noninvoluting (NICH) vs. partially involuting subtypes
- RICH > > NICH, PICH in liver
- Only follow-up imaging or biopsy can determine subtype
- RICH is almost entirely involuted by 14 months of age
- Rapidly involuting (RICH) vs. noninvoluting (NICH) vs. partially involuting subtypes
- Infantile hemangioma (IH)
- Usually not present at birth
- Proliferating phase: Lesion(s) develop during 1st few weeks of life with rapid growth over next few months
- Involuting phase: Slow regression of lesion(s) over years, usually beginning by 12 months of age
- Hemangioma: Benign endothelial neoplasm occurring in soft tissues or viscera (especially liver: Most common benign hepatic tumor of infants)
IMAGING
General Features
Radiographic Findings
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Ji Y et al: Screening for infantile hepatic hemangioma in patients with cutaneous infantile hemangioma: a multicenter prospective study. J Am Acad Dermatol. 84(5):1378-84, 2021
- El-Ali AM et al: Contrast-enhanced ultrasound of congenital and infantile hemangiomas: preliminary results from a case series. AJR Am J Roentgenol. 214(3):658-64, 2020
- Macdonald A et al: Historical and contemporary management of infantile hepatic hemangioma: a 30-year single-center experience. Ann Surg. ePub, 2020
- McGuire A et al: Pediatric hepatic vascular tumors. Semin Pediatr Surg. 29(5):150970, 2020
- Iacobas I et al: Guidance document for hepatic hemangioma (infantile and congenital) evaluation and monitoring. J Pediatr. 203:294-300.e2, 2018
- Rialon KL et al: Risk factors for mortality in patients with multifocal and diffuse hepatic hemangiomas. J Pediatr Surg. 50(5):837-41, 2015
- Rialon KL et al: Impact of screening for hepatic hemangiomas in patients with multiple cutaneous infantile hemangiomas. Pediatr Dermatol. 32(6): 808-12, 2015
- Wassef M et al: Vascular anomalies classification: recommendations from the international society for the study of vascular anomalies. Pediatrics. 136(1):e203-14, 2015
- Hsi Dickie B et al: Hepatic vascular tumors. Semin Pediatr Surg. 23(4):168-72, 2014
- Liang MG et al: Infantile and congenital hemangiomas. Semin Pediatr Surg. 23(4):162-7, 2014
- Kulungowski AM et al: Lessons from a liver hemangioma registry: subtype classification. J Pediatr Surg. 47(1):165-70, 2012
- Roebuck D et al: Rapidly involuting congenital haemangioma (RICH) of the liver. Pediatr Radiol. 42(3):308-14, 2012
- Chung EM et al: From the archives of the AFIP: pediatric liver masses: radiologic-pathologic correlation. Part 2. Malignant tumors. Radiographics. 31(2):483-507, 2011
- Restrepo R et al: Hemangiomas revisited: the useful, the unusual and the new. Part 1: overview and clinical and imaging characteristics. Pediatr Radiol. 41(7):895-904, 2011
- Restrepo R et al: Hemangiomas revisited: the useful, the unusual and the new. Part 2: endangering hemangiomas and treatment. Pediatr Radiol. 41(7):905-15, 2011
- Chung EM et al: From the archives of the AFIP: pediatric liver masses: radiologic-pathologic correlation part 1. Benign tumors. Radiographics. 30(3):801-26, 2010
- Christison-Lagay ER et al: Hepatic hemangiomas: subtype classification and development of a clinical practice algorithm and registry. J Pediatr Surg. 42(1):62-7; discussion 67-8, 2007
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Clinical Issues
TERMINOLOGY
Synonyms
- Not hemangioendothelioma (more aggressive vascular tumor, not typically found in infantile liver)
- Not cavernous hemangioma (venous malformation, not typically found in infantile liver)
Definitions
- Hemangioma: Benign endothelial neoplasm occurring in soft tissues or viscera (especially liver: Most common benign hepatic tumor of infants)
- 70% of 2009 publications used term hemangioma incorrectly
- Congenital hemangioma (CH): Found in perinatal period; does not proliferate beyond birth
- Rapidly involuting (RICH) vs. noninvoluting (NICH) vs. partially involuting subtypes
- RICH > > NICH, PICH in liver
- Only follow-up imaging or biopsy can determine subtype
- RICH is almost entirely involuted by 14 months of age
- Rapidly involuting (RICH) vs. noninvoluting (NICH) vs. partially involuting subtypes
- Infantile hemangioma (IH)
- Usually not present at birth
- Proliferating phase: Lesion(s) develop during 1st few weeks of life with rapid growth over next few months
- Involuting phase: Slow regression of lesion(s) over years, usually beginning by 12 months of age
- Hemangioma: Benign endothelial neoplasm occurring in soft tissues or viscera (especially liver: Most common benign hepatic tumor of infants)
IMAGING
General Features
Radiographic Findings
Ultrasonographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Ji Y et al: Screening for infantile hepatic hemangioma in patients with cutaneous infantile hemangioma: a multicenter prospective study. J Am Acad Dermatol. 84(5):1378-84, 2021
- El-Ali AM et al: Contrast-enhanced ultrasound of congenital and infantile hemangiomas: preliminary results from a case series. AJR Am J Roentgenol. 214(3):658-64, 2020
- Macdonald A et al: Historical and contemporary management of infantile hepatic hemangioma: a 30-year single-center experience. Ann Surg. ePub, 2020
- McGuire A et al: Pediatric hepatic vascular tumors. Semin Pediatr Surg. 29(5):150970, 2020
- Iacobas I et al: Guidance document for hepatic hemangioma (infantile and congenital) evaluation and monitoring. J Pediatr. 203:294-300.e2, 2018
- Rialon KL et al: Risk factors for mortality in patients with multifocal and diffuse hepatic hemangiomas. J Pediatr Surg. 50(5):837-41, 2015
- Rialon KL et al: Impact of screening for hepatic hemangiomas in patients with multiple cutaneous infantile hemangiomas. Pediatr Dermatol. 32(6): 808-12, 2015
- Wassef M et al: Vascular anomalies classification: recommendations from the international society for the study of vascular anomalies. Pediatrics. 136(1):e203-14, 2015
- Hsi Dickie B et al: Hepatic vascular tumors. Semin Pediatr Surg. 23(4):168-72, 2014
- Liang MG et al: Infantile and congenital hemangiomas. Semin Pediatr Surg. 23(4):162-7, 2014
- Kulungowski AM et al: Lessons from a liver hemangioma registry: subtype classification. J Pediatr Surg. 47(1):165-70, 2012
- Roebuck D et al: Rapidly involuting congenital haemangioma (RICH) of the liver. Pediatr Radiol. 42(3):308-14, 2012
- Chung EM et al: From the archives of the AFIP: pediatric liver masses: radiologic-pathologic correlation. Part 2. Malignant tumors. Radiographics. 31(2):483-507, 2011
- Restrepo R et al: Hemangiomas revisited: the useful, the unusual and the new. Part 1: overview and clinical and imaging characteristics. Pediatr Radiol. 41(7):895-904, 2011
- Restrepo R et al: Hemangiomas revisited: the useful, the unusual and the new. Part 2: endangering hemangiomas and treatment. Pediatr Radiol. 41(7):905-15, 2011
- Chung EM et al: From the archives of the AFIP: pediatric liver masses: radiologic-pathologic correlation part 1. Benign tumors. Radiographics. 30(3):801-26, 2010
- Christison-Lagay ER et al: Hepatic hemangiomas: subtype classification and development of a clinical practice algorithm and registry. J Pediatr Surg. 42(1):62-7; discussion 67-8, 2007
