Rapid growth of liver hemangioma following interferon treatment for hepatitis C in a young woman

Liver hemangioma is the most common benign liver tumor. Giant hemangiomas can grow and give various clinical symptoms. We describe a case of rapid growth of liver hemangioma in a seventeen-year-old girl. She was treated with interferon alpha 2b for hepatitis C. About 12 months later she was admitted to the hospital with symptoms of large epigastric mass, anemia and thrombocytopenia. Ultrasound scan and computed tomography confirmed the clinical picture, suggesting giant liver hemangioma. During surgery large cavernous hemangioma deeply penetrating into normal liver parenchyma was found. In view of recent hepatitis C infection the resection procedure (left extended hemihepatectomy) was assessed as being dangerous for the patient's life. Ligation of the left branches of hepatic artery and portal vein reducing tumor blood supply was performed. The postoperative period was uneventful; the hemangioma in the left lobe had shrunk. Ultrasound and CT scans performed one and two years after surgery showed that the size of the hemangioma remained stable and the patient was asymptomatic. In this described case three potential factors stimulating the growth of hemangioma (puberty, hepatitis C infection and interferon treatment) are discussed. The potential role of vascular endothelial growth factor and fibroblast growth factor is raised.