Giant cavernous hemangiomas of liver mimicking metastasis.

Most hepatic hemangiomas are small and symptomless. These are now being increasingly diagnosed with the greater use of scanning procedures. Hemangiomas can occasionally grow to a large size and become manifest to the patient and the clinician. Giant hemangiomas can produce symptoms including awareness of abdominal mass, pain due to thrombosis, and very rarely, rupture. Though ultrasound is known to be quite suggestive of the diagnosis, large hemangiomas may be mistaken for liver metastases due to their enormous size and variegated picture on the scanning procedure. Dynamic CT scan and at times MRI may be required for confirmation of the diagnosis. Needle biopsy is contraindicated if the diagnosis is suspected.