Case Author(s): Hamid Latifi,MD, Jerold Wallis, MD , 3/31/95 . Rating: #D2, #Q3

Diagnosis: Cavernous hemangioma

Brief history:

66 year old man with right upper abdominal pain


Transaxial(top row) and coronal(bottom row) tomographic images obtained one hour after administration of Tc-99m labeled red blood cells.

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Full history/Diagnosis is available below

Diagnosis: Cavernous hemangioma

Full history:

66-year old man with elevated liver function tests and right upper quadrant pain who had a sonogram on 3-17-95 at an outside hospital. The sonogram showed a hyperechoic lesion in the posterior segment of the hepatic lobe, measuring approximately 3 cm. The current examination was performed to confirm that this lesion represents a benign cavernous hemangioma.


Delayed tomographic images, demonstrate increased blood pool activity in the lateral aspect of the posterior segment of the right hepatic lobe, measuring approximately 2.5-3 cm in diameter. This area of scintigraphic abnormality corresponds to the sonographic finding and is diagnostic of a cavernous hemangioma.


The sonographic findings in this case were slightly atypical due to some areas of hypoechogenecity within the central parts of this lesion. Therefore, hepatic blood pool scintigraphy was recommended. On hepatic blood pool imaging, the characteristic appearance of a cavernous hemangioma is found. This appearance is extremely specific.

Major teaching point(s):

This case demonstrates the value of hepatic blood pool scintigraphy in confirmation of hepatic cavernous hemangioma. Tomographic images are especially helpful in smaller lesions (less than 3-4 cm in diameter); however, lesions less than 1.5 cm may not be visualized by scintigraphic techniques.

Differential Diagnosis List

A single case of hepatic angiosarcoma mimicking cavernous hemangioma has been reported.

ACR Codes and Keywords:

References and General Discussion of (Anatomic field:Gasterointestinal System, Category:Neoplasm, Neoplastic-like condition)

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Case number: hp001

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