Case Report on Rare Presentation of Hepatic Cavernous Haemangioma with Diffuse Hemangiomatosis from Yekatit 12 Hospital Medical College Addis Ababa, Ethiopia

Hepatic hemangiomas are the most common liver tumors. They are usually small and asymptomatic, and most often detected incidentally due to the increasing use of imaging modalities. While hemangiomas can occur at any age, they are most commonly found in individuals in their 4th to 6th decade. The majority of haemangiomas are less than 5 cm in size, while those larger than 10 cm are classified as giant hemangiomas. Most of the hemangiomas are solitary, but in 40% of cases, it may involve both right and left lobes and in rare cases, it is associated with diffuse hemangiomatosis. Most hemangiomas are asymptomatic but rarely they may present as an abdominal mass or pain. Large lesions located in the left lobe of the liver may cause pressure effects on adjacent structures such as stomach and bile duct causing nausea leading to anorexia, nausea and jaundice. Rarely large hemangiomas may compress Inferior Vena cava and patients may present with lower limb edema. The diagnosis of hepatic haemangioma mostly depends on cross-sectional imaging. Modalities like CT and MRI are used to diagnose hemangioma and to rule out other differential diagnoses, such as cysts, hepatic adenomas, hepatocellular carcinoma, and distant metastases. Laboratory tests like α-fetoprotein (AFP), carcinoembryonic antigen (CEA), cancer antigen 125 (CA 125) and cancer antigen 19-9 (CA19-9) are important to help rule out malignant lesions. Most hemangiomas do not require any surgical management. However, in patients who present with bothersome symptoms, have a larger size (greater than 10 cm), experience complications like rupture, or have lesions where malignancy cannot be ruled out, surgical treatment should be considered. In our case, the patient presented with compression effects and was diagnosed with a huge hemangioma with hemangiomatous. Resection was performed, and the patient was relieved of symptoms after the surgical intervention.