Case 70:   Hemangioma (infantile)

Diagnostic Categories:

Clinical Presentation:

11 week old girl diagnosed in utero with a large vascular liver lesion, with subsequent high output heart failure and Kasabach-Meritt syndrome (anemia, thrombocytopenia and consumptive coagulopathy).

CT: Hypervascular

Imaging Findings:

CT shows large infantile hepatic hemangioma (formerly: infantile hepatic hemangioendothelioma) occupying the majority of the left lobe of the liver. Focal extrahepatic hyperdensity posteriorly, best seen on the unenhanced image, represents material from previous embolization procedures.

The medial branch of the left hepatic vein is markedly dilated and tortuous, filling on arterial phase, consistent with arteriovenous shunting. Equilibrium phase shows blood pool density, suggestive of vascular nature of the mass. There are also numerous small periumbilical varices in the anterior abdominal wall on arterial phase. The celiac axis is prominent, larger than expected (not shown).