The Korean Journal of Hepatology 2010;16:410-413 DOI: 10.3350/kjhep.2010.16.4.410 Liver Pathology Sclerosed hemangioma of the liver So-Young Jin Department of Pathology, Soon Chun Hyang University Hospital, Soon Chun Hyang University College of Medicine, Seoul, Korea INTRODUCTION Cavernous hemangioma of the liver is the most common benign neoplasm, and the liver is its most common visceral site, having been found at that location in about 19% of cases in one series.1 It is usually found incidentally during a radiologic workup. However, it can result in specific symptoms or manifest with large size or enlargement. Cavernous hemangiomas usually present as solitary well-delineated, subcapsular, discolored nodules that are smaller than 5 cm. They can exhibit various forms of pathology, such as necrosis, scarring, and calcification, some of which mimic the primary or metastatic malignancy. We present herein a case of sclerosed hemangioma in a 52-year-old man. We discuss the histopathologic features of this case along with another case of giant cavernous hemangioma of the liver. CASE SUMMARY A 52-year-old male was transferred to our hospital for surgery of liver mass. He had visited an affiliated hospital of our uni- versity and had undergone surgery to repair a C-spine disc herniation 1 month previously. A liver mass was found during the preoperative workup. The initial hematologic and blood chemistry data were as follows: 5,100/μL white blood cell count, 12.8 g/dL hemoglobin, 175,000/μL platelet count, 21 mg/dL blood urea nitrogen, 0.7 mg/dL creatinine, 4.2 g/dL albumin, 33 IU/L aspartate aminotransferase, 40 IU/L alanine aminotransferase, and 0.7 mg/dL total bilirubin. He was positive for hepatitis B Keywords: Liver; Hemangioma; Sclerosed variant (HB) surface antigen (HBsAg) and anti-HBe, and negative for anti-HBs and HBeAg. The alpha-fetoprotein level was 1148.2 ng/mL, and carcinoembryonic antigen and cancer antigen 19-9 levels were in the normal ranges. Dynamic computed tomography (CT) disclosed a 3.8×3.2 ×3.1 cm-sized mass with a bulging contour in the lateral segment of the liver that was well enhanced in the arterial phase and showed a subtle low density with focal capsular enhancement in the delayed phase. This mass demonstrated a low signal intensity on T1-weighted image and a high signal intensity on T2-weighted image. It was enhanced and washed out with low signal intensity in the hepatobiliary phase, making it compatible with typical hepatocellular carcinoma. Another enhanced mass was noted in segment 6, with marginal globular and gradual internal enhance- ment on dynamic CT. Magnetic resonance image (MRI) demon- strated a low signal intensity on T1-weighted image and a slight- ly high signal intensity on T2-weighted image. It exhibited subtle marginal enhancement on delayed phase and well-demar- cated low signal intensity on hepatobiliary phase. Based on the radiologic findings, hemangioma or well-differentiated hep- atocellular carcinoma in a dysplastic nodule were suspected. Given the impression of two hepatocellular carcinomas, or else one hepatocellular carcinoma and another lesion, a left lateral segmentectomy and wedge resection of segment 6 were performed. PATHOLOGIC FINDINGS The resected left liver weighed 155 g and measured 12×8×4 Corresponding author: So-Young Jin Department of Pathology, Soon Chun Hyang University Hospital, 22 Daesagwan-gil, Yongsan-gu, Seoul 140-743, Korea Tel. +82-2-709-9424, Fax. +82-2-790-5820, E-mail; jin0924@schmc.ac.kr Copyrights Ⓒ 2010 by The Korean Association for the Study of the Liver The Korean Journal of Hepatology∙pISSN: 1738-222X eISSN: 2093-8047