Many patients, having seen the word “tumor” in their diagnosis, experience shock. Even the doctors’s explanation that the neoplasm is still benign does not soothe them very much. However, there are tumors with which people live beautifully for many years, not suspecting that they have such a pathology. One of them is liver hemangioma, the causes of which are still not precisely defined. Many doctors classify this ailment as rare, although it is found in 7% of the world's inhabitants.
In the article we will tell you what it is - hemangioma of the liver. Treatment with medications and alternative methods of this ailment can give good results, but only if measures are taken on time. If not, the patient may die from bleeding that has become the culprit of this "harmless" tumor.
General information
Hemangioma is inherently a benign tumor of blood vessels in which there are certain pathologies. Such vessels are arranged randomly, grow uncontrollably and do not fulfill their main role, which consists in transporting oxygen and nutrients to the organs. Such neoplasms can occur on any part of the body and in any organ - in the liver, in the kidneys, in the ovaries. Even in the brain and spinal cord, they can appear.
Here are a few interesting facts that will help to understand what it is - liver hemangioma. Treatment and preventive measures for this pathology are carried out only in individual cases, which will be discussed below. Mostly doctors take a wait-and-see attitude, since in 90% of children hemangiomas resolve by 10 years by themselves, leaving no trace.
In girls, such formations are observed about 7 times more often than in boys (according to some sources, 4 times), and the smaller the baby’s weight, the larger the tumor.
A pleasant and very important feature of these formations is that they never develop into cancer.
Causes of liver hemangioma in children
The etiology of this pathology is not fully understood. In principle, this can be said of all benign and malignant tumors. The causes of their occurrence are in the area of ​​speculation. If we talk about liver hemangioma observed in infants, experts attribute its appearance to adverse events during pregnancy (up to 12 weeks) that can affect the formation of fetal blood vessels. This includes all the known causes that negatively affect the development of the embryo:
- Hereditary factor.
- Transfer of diseases by a future mother. Regarding hemangiomas, flu and acute respiratory viral infections are especially dangerous, since the viruses that cause them release toxins that negatively affect the formation of blood vessels.
- Constant stress in the first trimester.
- The use of certain drugs.
- Lack of vitamins in the diet of a pregnant woman.
- Smoking and drinking.
Symptoms
Not only the causes of liver hemangioma are not completely clear. And the treatment of this pathology also does not have a clear algorithm. As noted above, most doctors only monitor the state of the tumor, if it so happened that it was discovered. The fact is that liver hemangioma in most people does not manifest itself in any way. People live with her until old age and do not suspect that they have such a pathology. This mainly concerns small single tumors, which have almost no effect on the functioning of the liver.
If there are several hemangiomas in the liver or it is one, but of very large sizes (from 5 cm and above), a person may have symptoms that are difficult to ignore:
- Liver enlargement.
- Pain or unexplained discomfort in the right side.
- Nausea worse after eating fried, spicy foods.
In rare cases, when the hemangioma of the liver reaches very large volumes (weight - 1500 grams or more), it can compress the bile ducts. Then the patient may additionally have the following symptoms:
- Vomiting
- Dark urine.
- Yellowing of the skin and sclera of the eyes.
- Pressure problems.
- Fatigue (a person cannot run or walk quickly, as he immediately has pain in his right side).
- Swelling of the legs if the inferior vena cava is compressed by a tumor.
What is it - liver hemangioma in adults
This pathology is found mainly in women of young and middle age (from 30 to 50 years). Doctors attribute this to the peculiarity of the work of female hormones. Hemangioma in adults is the same as in children, that is, a benign vascular tumor. It is formed from intertwined abnormal vessels filled with blood. The difference may be that over the years in adults, blood congestion can increase significantly, sometimes reaching 5 kg or more. An incredible case was recorded when the tumor weighed 35 kg!
The causes of liver hemangioma in adults can be:
- Improper vascular development at the embryo stage.
- Liver injury.
- Endocrine diseases.
- Hormonal disorders.
- Reception of hormonal contraceptives.
Of course, too large a tumor negatively affects neighboring tissues, compresses the bile ducts and normally developed vessels. This explains why the symptoms of hemangiomas in adults are often more pronounced than in children. In adults, there are:
- Liver enlargement.
- Unpleasant sensations, pain, pressure, heaviness in the right side.
- Nausea after eating.
- Sometimes there is vomiting (especially after eating fatty and spicy foods, large doses of alcohol).
- Swelling of the legs.
- Yellowness of sclera and skin.
In adults, often at the same time as hemangioma, other pathological formations are found - cysts, diseases of the bile ducts, gall bladder, hernia in the esophagus. Each of these deviations from the norm adds its own symptomatology. For example, with problems with bile, there is a bitter aftertaste in the mouth, flatulence, irritability, itchy skin, stool disturbance, and with a hernia - heartburn, belching, rotten or sour, burping food, difficulty swallowing. These symptoms do not indicate hemangioma, but if they are present, it is necessary to check the condition of the liver.
Classification
There are four types of liver hemangioma:
- Capillary. Small vessels take part in its formation. For this reason, such tumors are very small (up to 2 cm), and it is much more difficult to identify them.
- Cavernous. It is formed by the merger of larger vessels in diameter. Such a tumor may be 5 or more centimeters in size. Often it is a cavity filled with blood, due to the addition of which the tumor grows.
- Membrane It differs in that multiple septa are observed in the tumor.
- Mixed. This type is observed very rarely and is present in the liver and capillary and cavernous hemangiomas. This often leads to liver failure, and subsequently to cirrhosis.
Note that in the vast majority of cases, people find either capillary or cavernous hemangioma, and it is most often located in the right lobe of the liver.
Complications
Can liver hemangioma be harmful to human health, since it does not turn into cancer, almost does not cause trouble, plus it resolves itself? It turns out maybe. In some circumstances, this tumor, a cavity filled with blood, may burst, resulting in massive bleeding. Moreover, mortality is observed in 80% of cases.
Hemangiomas can cause rupture:
- Liver injuries (stroke, bruise).
- Sudden movements.
- High loads (e.g. lifting the bar).
Symptoms of this phenomenon are very characteristic:
- A sharp stitching and cutting pain that appears suddenly and spreads throughout the peritoneum.
- Pressure reduction.
- Violation of the heart, lungs.
- Cold sweat.
- Loss of consciousness.
- Coma.
In view of such a deadly complication of liver hemangioma, it is advisable to identify and observe its growth dynamics in time.
Diagnostics
Even if there are no obvious symptoms in the pathology described by us, it is advisable to diagnose and treat liver hemangioma. The reasons for its rupture can be the most mundane, from which no one is safe (for example, a person tripped or slipped on a slippery road and fell unsuccessfully), and the consequences of such an injury are always serious. Even if you manage to save the patient’s life, internal bleeding will require long-term treatment and rehabilitation.
Most often, this tumor in the liver is detected by conducting routine (physical examination) or other examinations due to any diseases of the internal organs.
It is possible to notice a tumor in the liver with such hardware types of diagnosis of the abdominal cavity:
If liver hemangioma is detected, additionally carried out:
- Celiacography (angiography of the celiac trunk).
- Hepatoscintigraphy (to ensure that the detected tumor is benign).
A successful study in the presence or absence of pathological symptoms in the liver is a biochemical analysis of plasma and blood, more commonly known as liver function tests. Blood is taken from a vein. A person should take this test on an empty stomach. A few days before the study, you can not take alcohol, eat fatty, fried, spicy foods. On the day of blood donation, do not smoke before visiting the laboratory.
Hepatic tests are performed for examination of both children and adults, but the norms of all indicators for different age categories are not the same.
If hemangioma is suspected, the amount of albumin in the plasma is determined. If it is less than normal, this may indicate many pathologies in the liver, including hemangioma.
Also determine the amount of bilirubin, transaminases Alt and AcT, GGTP, prothrombin time.
Since doctors call the hereditary factor one of the causes of hemangioma in the liver, genetic markers are studied during the diagnosis . Scientists suggest that this pathology often develops in people with the 2nd blood group.
Hemangiomas are not punctured, as this can cause bleeding.
Learn more about hardware research.
What is ultrasound, CT and MRI, everyone knows, so we will not dwell on them. Let's talk about other studies, which so far are not known to everyone.
Celiacography allows you to recreate the picture of blood flow in the vessels. It is performed by introducing a contrast medium, after which an angiogram is made. The procedure is expensive. In Moscow, the average price is 19,300 rubles (for comparison, we note that the MSCT, described below, costs from 6300 rubles).
The method of hardware research of MSCT is the same computed tomography, only spiral. When it is performed, the tomograph tube continuously rotates, while it itself moves. As a result, it is possible to obtain three-dimensional images with a slice of only 0.5 mm. This study is very informative for diseases of the gallbladder, pancreas, spleen, lymph nodes and liver hemangiomas.
Hepatoscintigraphy is an effective and relatively inexpensive (from 5700 rubles) study using a radio indicator inserted into the liver. The drug is distributed over its volume and begins to emit specific signals. Using them, the operator can accurately determine the presence, location and magnitude of not only liver hemangiomas, but also changes in the parenchyma, hepatomegaly, portal hypertension.
Treatment criteria
Given the high mortality at rupture of hemangiomas, it is logical to assume that a course of therapy is necessary when it is detected. However, in practice, everything is different. In children, such a tumor is not treated in 99% of cases, since it has an excellent property to resolve independently with age.
The treatment of liver hemangiomas in adults, depending on the clinical indications, is carried out by different methods: conservative, folk, surgical, non-invasive, based on new technologies.
A few words about the size. Hemangioma only in individual, very rare cases is round, which allows us to talk about its diameter. In most patients, it has an arbitrary shape. Its value is usually measured in three projections where its cross section is maximum.
Regardless of whether the hemangioma is large or small, if it does not bother the patient at all, treatment is not prescribed. Doctors only monitor the dynamics of its growth. For this purpose, the patient performs an ultrasound of the liver every six months.
Conservative and alternative methods of therapy
At the moment, official medicine offers a therapeutic course using means that correct the presence and quantity of hormones. In each case, the doctor prescribes the funds individually, based on the results of the tests, the location and size of the tumor.
Great help is provided by alternative treatment of liver hemangiomas. Many healers have accumulated many recipes. Each uses only natural products.
Drugs have various effects:
- Strengthen the immune system.
- Remove symptoms (pain, nausea).
- Relieve inflammation of neighboring organs caused by tumor pressure.
- They have choleretic properties, which reduce the load on the liver.
- Restore the liver after surgery.
They do not resorb the tumor and do not reduce in size.
We offer several recipes:
- Tea mushroom. Whoever has it, they drink infused tea for the prevention of any disease. In addition, the drink itself tastes good. A mushroom is a living creature, it needs to be grown on a sweet tea broth. Drink a drink several times a day. This tool has a lot of therapeutic effects, including choleretic, restorative, anti-inflammatory.
- Honey. This product has a lot of useful substances. It is used for the prevention and treatment of dozens of ailments. To improve the condition with liver hemangioma, you need to drink a glass of warm water every morning in which a teaspoon of honey is diluted. After this, you need to lie down on your right side for 15 minutes.
- Pumpkin, mint and milk thistle. Take 200 ml of pumpkin oil, 100 ml of milk thistle oil (you can prepare it yourself, from the seeds of the plant, which must be infused in ordinary oil for two weeks), 5 drops of peppermint essential oil. Mix everything thoroughly. Take 30 days in a spoon half an hour before breakfast.
- Seeds of oats. Fill a glass with them (slightly below the edge), fill with ordinary water, leave for 10 hours. Seeds should swell. After that, they need to be boiled over low heat for half an hour, leave to infuse for another 12 hours. Strain. Add 1 liter of boiled water to the resulting broth. Use three times a day for 100 ml.
Surgical methods
Treatment with folk remedies for liver hemangiomas can only be used as an adjunct to reduce symptoms (if any) and to improve the functioning of all body systems.
Surgical treatment is carried out in such situations:
- Rupture of the vessels of the tumor and the opening bleeding.
- The size of the neoplasm is more than 50 mm.
- Growth dynamics (if the tumor size increases by 50% or more per year).
- Severe symptoms associated with the influence of hemangiomas on adjacent tissues.
- The assumption that the tumor is malignant.
There are two types of liver operations:
- Lobectomy It consists in removing only the segment of the liver where the tumor is located. The cost of such an operation in Moscow is from 6500 rubles.
- Hemihepatectomy. It consists in removing from the 5th to the 8th segments of the liver. The cost of such surgical intervention is from 10 500 rubles.
Operations are not performed if patients have contraindications:
- Cirrhosis of the liver.
- Germination of hemangiomas in the main hepatic vessels.
- The location of the tumor in two lobes of the liver.
Invasive methods
Gentle and at the same time very effective treatment of liver hemangiomas is becoming more and more popular. These methods include:
1. Sclerosis. It is used not only for liver hemangioma, but also for the treatment of vascular diseases in other parts of the body. It consists in introducing a substance called a “sclerosant” into the vessels with a syringe. Under its influence, the vessels stick together, which prevents the flow of blood to the tumor and its further growth.
2. Embolization. In this procedure, under local anesthesia, emboli are injected into the blood vessels of the liver, which clog their gaps. As a result, new portions of blood stop flowing to the tumor.
3. Microwave radiation and liquid nitrogen. This method successfully treats hemangiomas in children and adults. It is not traumatic, does not cause bleeding. Vessels under the influence of microwave rays and nitrogen, supplied at very low temperatures, are destroyed, and there is no scarring.
4. Laser therapy. Based on the fact that the laser beam glues the blood vessels, due to which the flow into the hemangioma of blood stops. The method has contraindications:
- Insulin addiction.
- Epilepsy.
- Infectious diseases.
- The presence of oncology in any organ.
5. Electrocoagulation. It is mainly used to remove neoplasms on the skin (moles, warts, nevuses). The method is based on the burning of formations with a special element heated to high temperatures. If the device, called an electrocoagulator, operates in monopolar mode, bleeding stops in the vessel. In addition, doctors began to use an innovative method based on the introduction of specific substances into pathological vessels, which are heated to high temperatures and burn out the tumor, and the dead tissue is subsequently split.
Opinions of doctors and patients
The vast majority of doctors believe that liver hemangioma, which does not make itself felt and does not prevent a person from living calmly, should not be treated. At numerous medical forums, experts explain to people that with this pathology you can play sports, give birth to children, work in any specialty.
Patients in reviews of liver hemangioma with full optimism express that its treatment does not cause any complications. Health after surgery or other medical influences is fully restored.
Some patients note that their hemangioma in the liver disappeared after hirudotherapy, although doctors do not recommend this method.
Doctors Recommendations
Preventive measures against diseases in the development of which the factor of heredity is involved, as such, is not. Doctors observing patients with liver hemangioma speak of the same thing. To reduce the risk of vascular pathologies in the fetus, there are standard recommendations for pregnant women:
- Do not take alcohol.
- Do not smoke.
- Eat vitamin-rich foods.
- Do not take any medicine without the advice of a doctor.
- Pass all necessary examinations.
To reduce the risk of developing hemangiomas in adults, it is recommended that all hormonal preparations be taken with great care.
With liver hemangioma, an important role is played by proper nutrition. Nutritionists for those who have this pathology, appoint table number 5. According to the recommendations of specialists, you can use the following products:
- Porridge.
- Dietary sausages.
- Low-fat meat (chicken, turkey, beef).
- Olive oil.
- Fruits.
- Low-fat dairy products.
- Honey.
- Kissels and compotes.
- Rosehip broth.
- River fish.
- Some vegetables (zucchini, potatoes, cucumbers).
Exclude from the menu you need:
- Fried, spicy, smoked foods.
- Carbonated drinks.
- Vegetables (cabbage, radish, radish, sorrel).
- Fatty meat (pork, lamb).
- Coffee, chocolate.
- Fatty dairy products.
- Sea fish.
- Alcohol.
It is important to remember that even authorized products should be consumed in small portions, but from 4 to 6 times a day.