Thrombosed hepatic cavernous hemangioma

Case contributed by Chris O'Donnell
Diagnosis certain


Acute right upper quadrant pain. The ultrasound shows an echogenic mass in the liver. MRI for clarification

Patient Data

Age: 45 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Typical cavernous haemangiona of the liver ie bright on T2 with intense peripheral enhancement on the arterial phase contrast-enhanced dynamic with "filling in" over time.  The upper portion, however, contains an atypical T1 hyperintense, mixed T2 signal mass that does not enhance.  This is in keeping with subacute hemorrhage (methemoglobin)

Follow-up MRI shows reduction in size of the intracavernous thrombus.

Case Discussion

Spontaneous thrombosis of cavernous hemangioma of the liver is rare but should not be confused with sclerosing or hyalinized hemangioma where the vascular channels are obliterated with fibrous tissue, not T1 hyperintense material (methemoglobin) as in this case.

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