So-Young Jin. Sclerosed hemangioma of the liver 413 (Fig. 3B). Areas of gray-white scarring can be present. Microscopically, The principal management of cavernous hemangioma of the cavernous hemangiomas comprise cavernous vascular spaces liver is conservative. It will be helpful to understand the natural lined by flattened endothelium with fibrous septa (Fig. 4). involution stages of this lesion. However, pathologic confirmation Thrombosis and phleboliths are evident, and variable pro- of the mass is mandatory if the possibility of malignancy cannot portions of scarring and calcification complicate the histopatho- be ruled out. logic features. The hemangioma is basically a type of hamartoma. Female sex hormones may play some role in its development and progression. Makhlouf and Ishak4 compared the findings between sclerosed hemangioma and sclerosing cavernous hemangioma. According to their theory, recent hemorrhages and hemosiderin deposits, rich with mast cells are present in the scle- rosing hemangioma. Moreover, fibrosis, increased elastic fibers, and dystrophic or psammomatous calcifications with a decreased number of mast cells can be observed in the sclerosed hemangioma. Based on these findings, they suggest the involve- ment of the mast cells in angiogenesis, regression, and fibrosis. REFERENCES 1. Ishak KG, Goodman ZD, Stocker JT. Atlas of tumor pathology: Tumors of the liver and intrahepatic bile ducts. 3rd series, Fascicle 31. Washington D.C.: Armed Forces Institute of Pathology, 2001:87-93. 2. Shim KS, Suh JM, Yang YS, Kim JG, Kang SJ, Jeon JS, et al. Sclerosis of hepatic cavernous hemangioma: CT findings and pathologic correlation. J Korean Med Sci 1995;10:294-297. 3. Park SM, Shin SM, Seo HE, Kim SH, Kim HS, Park JH, et al. A case of sclerosed hemangioma mimicking intrahepatic cholangiocarcinoma. Korean J Gastroenterol 2009;54:399-403. 4. Makhlouf HR, Ishak KG. Sclerosed hemangioma and sclerosing cavernous hemangioma of the liver: a comparative clinicopathologic and immunohistochemical study with emphasis on the role of mast cells in their histogenesis. Liver 2002;22:70-78.