Background : Hemangioma is the most common benign liver tumor. Most patients with hepatic hemangioma were asymptomatic. When their largest diameter is more than 10 cm, they are classified as giants. Known as enormous haemangiomas, these extremely rare presentations measure more than 15 cm. Giant and enormous hepatic cavernous hemangiomas are often symptomatic and require surgical management. This study aimed to describe the clinical findings, diagnostic approach, risk factors, and evaluate the outcome of surgical treatment for giant and enormous hepatic hemangioma.

Methods : We performed a retrospective analysis of patients with giant and enormous hepatic hemangioma treated in the Department of Hepato-Biliary-Pancreatic Surgery, Military Central Hospital 108 from September 2015 to December 2022. The medical records of each patient were reviewed to obtain the clinical and surgical data.

Results : Elective surgery was performed for 23 patients who had giant and enormous hepatic hemangioma. The median diameter of giant hepatic hemangioma was 13,5 ± 8,7 cm (10 - 28 cm). Indication of surgery management: abdominal pain (86.9%), rapid growth (13.1%). Enucleation was performed for 10 (43,7%) patients and anatomical liver resection was required in 13 (56,3%) patients. The median blood transfusion was 202.86 ± 211.21 ml, the need of blood transfusion was required in 2 (8,6%) patients, and the median operation time was 143.13 ± 44.23 min. Postoperative complications occurred in 2 (8.6%) patients, including: bile leakage 1 (4.3%) patients, bleeding 01 (4.3%) patient. The average length of hospital stay was 8.53 ± 1.76 days.

Conclusions : The main indication for surgery is giant and enormous hepatic cavenous hemangioma, with or without symptoms of tumors. Both enucleation and liver resection are safe and effective surgical treatments for giant and enormous hepatic hemangiomas.