Haemangioma

• Most common benign tumour of mesenchymal origin
  • Incidence in autopsy series is 8%
• Red-purple hypervascular lesions
• Lesions are normally separated from normal liver by ring of fibrous tissue
• Typical lesions are usually <4cm in size and asymptomatic, being found incidentally
• However larger lesions (giant or cavernous haemangiomas) can be up to 20cm+, and can cause symptoms including abdominal pain, nausea and vomiting and bleeding
• On ultrasound they are typically hyperechoic
• Usually managed through observation only
• If symptomatic or rapidly enlarging, options include surgery, arterial embolisation or radiofrequency ablation

Liver cell adenoma

• 90% develop in women in their third to fifth decade
• Linked to use of oral contraceptive pill 💊
• Lesions are usually solitary
• They are usually sharply demarcated from normal liver although they usually lack a fibrous capsule
• On ultrasound the appearances are of mixed echoity and heterogeneous texture.
  • On CT most lesions are hypodense when imaged prior to administration of IV contrast agents
• In patients with haemorrhage or symptoms, removal of the adenoma may be required

Mesenchymal hamartomas