Work

Cystic degeneration of a giant cavernous hepatic hemangioma in a child: A case report

Year: 2026

Type: article

Abstract: Introduction Hepatic hemangiomas are the most common benign vascular liver tumours in children. While typically solid, these lesions may rarely undergo cystic degeneration, significantly altering their radiological presentation. The resulting cystic morphology can closely mimic simple hepatic cysts or other cystic liver lesions on imaging, posing a major diagnostic pitfall — particularly in resource-limited settings where contrast-enhanced studies may be unavailable. Case presentation A 4-year-old girl presented with a 6-month history of progressive abdominal distension. A palpable, painless mass extended from the right flank to the left hypochondrium. Abdominal ultrasonography revealed a large hepatic cyst with communicating locules. Non-contrast abdominopelvic computed tomography showed a 17.2 × 12.1 × 9.8 cm hypodense cystic formation with internal septations in the right hepatic lobe, initially misdiagnosed as a simple hepatic cyst. Tumour markers including alpha-fetoprotein were normal. At surgery, aspiration yielded 1250 mL of clear serous fluid. A well-defined cleavage plane allowed complete excision of the mass from segments V and VIII. The cyst wall was thick with a highly vascularised internal lining. Histopathological examination revealed dilated vascular channels lined by flattened endothelial cells, confirming cavernous hemangioma. Recovery was uneventful, and the patient remained asymptomatic at 3 months' follow-up. Conclusion Extensive cystic degeneration can make a cavernous hepatic hemangioma yield clear serous — not haemorrhagic — fluid and mimic a simple hepatic cyst; a non-haemorrhagic aspirate does not exclude a hemangioma. When contrast-enhanced imaging is unavailable, a thick vascularised wall and internal septations should redirect the differential toward a cystic vascular tumour.

Source: Journal of Pediatric Surgery Case Reports

DOI: 10.1016/j.epsc.2026.103342

Authors: Mahamoud Omid Ali Ada, Hellé Moustapha, Issoufou Yaro, Mansour Issoufou Hama Sidi, Habibou Abarchi

Institutions: Université Abdou Moumouni, National Hospital Niamey

Language: English

Topic: Vascular Malformations and Hemangiomas

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,130