Haemangioma

Haemangiomas are the most common benign liver lesions, occurring in up to 20% of the general population.

Haemangiomas are typically small (less than 4 cm) and solitary, although they can be large (greater than 10 cm) and occur in multiples. They can change in size over time.

On ultrasound, typical findings are of a homogeneous, hyperechoic lesion with sharp margins, posterior enhancement and absence of a ‘halo sign’. In lesions larger than 3 cm, the diagnosis should be confirmed using contrast-enhanced imaging (computed tomography [CT], magnetic resonance imaging [MRI]), which classically shows peripheral and globular enhancement of the lesion on arterial phase followed by a central enhancement (‘filling-in’) on delayed phases.

Haemangiomas are usually asymptomatic, even when large. A conservative approach is appropriate. Follow-up imaging is not required because these lesions are benign.

It is not necessary to discontinue combined oral contraceptives in patients with haemangioma, and follow-up during pregnancy is not required.