Multicystic cavernous hemangioma of the liver: report of a case including diagnostic imaging and pathologic correlation.

The case of a multicystic hemangioma in the liver of a 78-year-old woman is reported. The patient complained of upper abdominal pain and had been seen at a local hospital a few months prior to this admission. An endoscopic examination of the stomach revealed an active gastric ulcer, and ultrasonography (US) of the upper abdomen also incidentally detected a liver tumor. After treating the gastric ulcer, she was then referred to Ryukyu University Hospital in January 1997. US revealed a 3.5-cm, oval-shaped, echogenic tumor with multiple cystic areas in the right lobe of the liver. A CT scan demonstrated a hypodense tumor, that was not enhanced on dynamic CT. Angiography showed a hypovascular tumor that appeared to be a multicystic tumor of heterogeneous high intensity on T2-weighted MRI. The tumor measured 3.5 cm x 3.5 cm in size and was multicystic with a fibrous septum and serous fluid. Histologically the tumor was determined to be cavernous hemangioma of the liver. Atypical hemangiomas should be included in the differential diagnosis when hemangiomas show multicystic features.