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Background <p>Hepatic venous malformation (HVM), otherwise known as hepatic hemangiomas, is considered the most common benign liver tumor, and are estimated to occur in up to 20% of the population. Although this tumor originates from a vascular malformation, its underlying pathophysiology remains poorly understood.</p> Patients &amp; methods <p>This study is a prospective study—single-arm clinical trial. In this study, 14 patients with large symptomatic or asymptomatic significantly growing hepatic hemangiomas (more than 5&#xa0;cm) underwent percutaneous sclerotherapy by bleomycin with a follow-up study by contrast-enhanced cross-sectional imaging after 3&#xa0;months. This study was conducted in the interventional radiology unit in Ain Shams university hospital over the period from March 2024 to September 2024. The main source of data for this study was patients with large symptomatic hepatic hemangiomas referred to the IR unit.</p> Results <p>Percutaneous transhepatic sclerotherapy with a bleomycin–lipiodol mixture is a minimally invasive, effective alternative to surgery for large symptomatic hepatic hemangiomas, achieving 10–41% size reduction in the largest dimension and durable symptom relief with minimal complications. Compared to resection, it offers shorter procedures, faster recovery, fewer complications, and lower costs.</p> <p>Our study observed a statistically significant reduction in the lesion’s largest dimension. Just three months after the injection procedure, with the mean decreasing to 7.99 ± 3.18&#xa0;cm compared to 11.13 ± 3.2&#xa0;cm in the pre-injected lesions, median to 7.75&#xa0;cm (IQR: 6.5–10), and the range narrowing to 3.5–16&#xa0;cm compared to 6–17&#xa0;cm in the pre-injected lesions, with reduction in the lesion’s largest dimension of 10% to 41%, with follow-up only after 3&#xa0;months.</p> Conclusion <p>Percutaneous transhepatic sclerotherapy with bleomycin–lipiodol is a safe, effective, minimally invasive option for symptomatic giant hepatic hemangiomas, achieving significant lesion reduction and symptom relief with minimal complications. Despite promising outcomes, limitations include small sample sizes, short follow-up, and single-center data, highlighting the need for larger, multicenter prospective trials to validate long-term efficacy.</p>

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Percutaneous sclerotherapy for large hepatic hemangiomas

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Youssef Wahid Tantawy,
  • Ahmed Mohamed Abouelhoda,
  • Mohamed El-Gharib

摘要

Background

Hepatic venous malformation (HVM), otherwise known as hepatic hemangiomas, is considered the most common benign liver tumor, and are estimated to occur in up to 20% of the population. Although this tumor originates from a vascular malformation, its underlying pathophysiology remains poorly understood.

Patients & methods

This study is a prospective study—single-arm clinical trial. In this study, 14 patients with large symptomatic or asymptomatic significantly growing hepatic hemangiomas (more than 5 cm) underwent percutaneous sclerotherapy by bleomycin with a follow-up study by contrast-enhanced cross-sectional imaging after 3 months. This study was conducted in the interventional radiology unit in Ain Shams university hospital over the period from March 2024 to September 2024. The main source of data for this study was patients with large symptomatic hepatic hemangiomas referred to the IR unit.

Results

Percutaneous transhepatic sclerotherapy with a bleomycin–lipiodol mixture is a minimally invasive, effective alternative to surgery for large symptomatic hepatic hemangiomas, achieving 10–41% size reduction in the largest dimension and durable symptom relief with minimal complications. Compared to resection, it offers shorter procedures, faster recovery, fewer complications, and lower costs.

Our study observed a statistically significant reduction in the lesion’s largest dimension. Just three months after the injection procedure, with the mean decreasing to 7.99 ± 3.18 cm compared to 11.13 ± 3.2 cm in the pre-injected lesions, median to 7.75 cm (IQR: 6.5–10), and the range narrowing to 3.5–16 cm compared to 6–17 cm in the pre-injected lesions, with reduction in the lesion’s largest dimension of 10% to 41%, with follow-up only after 3 months.

Conclusion

Percutaneous transhepatic sclerotherapy with bleomycin–lipiodol is a safe, effective, minimally invasive option for symptomatic giant hepatic hemangiomas, achieving significant lesion reduction and symptom relief with minimal complications. Despite promising outcomes, limitations include small sample sizes, short follow-up, and single-center data, highlighting the need for larger, multicenter prospective trials to validate long-term efficacy.