Hemangioma in liver is more common than in the rest of the internal organs. In most cases the disease goes unnoticed and hemangioma may never show up. But with a large hemangioma of the liver there is a risk of its rupture and internal bleeding.

As it emerges and develops hepatic hemangioma

Hemangioma of the liver - a congenital abnormality of small veins of the liver, which is developed by weaving their walls. In the formation of hemangiomas involving all elements of the vein wall. Hemangioma of the liver occurs more often in women. Small hemangiomas usually random finding during surgery or after death for any other reason.

Typically, a hematoma of the liver has a cavernous character, that is, it is represented by large cavities (cavities) of different shapes filled with blood. The cavities are separated by thin walls of connective tissue lined with epithelium. In these cavities sometimes blood clots to form blood clots, which are then impregnated with salts and germinate connective tissue (organized).

Growing hemangioma of the liver is usually not inside in the liver tissue, and outwards, liver tissue (parenchymal) it strikes rarely.

How is Liver hemangioma

Hemangioma liver is usually asymptomatic and manifested only in the case becomes large. In this case, it may manifest symptoms such as nausea, vomiting, disorders of digestion of food, yellowness of the skin and mucous membranes, increased liver size.

With the growth of hemangiomas is great danger of a break with the advent of internal bleeding and signs of acute abdomen: sharp sudden pallor, abdominal pain and an inability to touch him (abdominal muscles reflexively tense and do not allow to press on your stomach). A sign of internal bleeding is a sharp drop in blood pressure, dizziness Dizziness - if the ground is slipping from under his feet   and loss of consciousness.

Another complication of hemangiomas of the liver may be its transformation into a malignant tumor Malignant tumor: cells are mad   (malignancy). But it is rare - hemangioma rarely maligniziruetsya.

Most hemangiomas of the liver may reveal in the case of squeezing her bile ducts, or adjacent organs, adhesions or the appearance of thrombosis Thrombosis - the cause of heart attack and stroke   veins of the liver.

Diagnostics

Little hemangioma liver are difficult to detect in most cases it is detected accidentally in the survey for other diseases. If some parts of hemangioma organized by impregnation with its salts and the formation of bony walls, it can be detected on the radiograph. To clarify the diagnosis is carried out computer tomography or magnetic resonance imaging (CT or MRI).

Sometimes it helps to confirm the diagnosis X-ray of blood vessels of the liver (hepatic angiography) at which the contrast agent fills the vascular space hemangiomas and long delays in them.

Treatment

Upon detection of hepatic hemangiomas at first she was being watched, of course, if there are no complications. This tactic is based on the fact that the true hemangioma grows rare in adults (usually, by contrast, tends to decrease) and maligniziruetsya. If there are suspected complications, then surgery is performed.

Indications for removal of liver hemangiomas are larger than 50 mm in diameter, surface layout, compression of surrounding organs, including biliary tract infection, increased suspicion for malignancy (degeneration into malignant tumor) or cancer of the liver Liver cancer: prognosis is poor, but there is hope . At the same time, unlike other types of tumors in the hemangioma is not carried out a biopsy - taking a piece of tumor tissue for histological examination as a great danger to cause bleeding. Therefore, in case of doubt, always carried a surgical operation - resection of the liver or cancer.

Contraindication to resection of the liver is a tumor-bearing large veins of the liver, cirrhosis (severe disease characterized by replacement of liver tissue by connective tissue with the loss of its function) and very large hemangiomas, which are located in both lobes of the liver (in this case, would be required to remove all of the liver, and without it, people can not live).

Conduct operations as liver resection and resection of the tumor with ligation of blood vessels supplying it. In addition, the operations supplying rentgenendovaskulyarioy occlusion of blood vessels and tumor puncture sclerotherapy.

Rentgenoehndovaskuljarnaja hepatic artery embolization (EPA) is carried out immediately after the X-ray examination of the blood vessels of the liver condition (angiography). Through a catheter in an artery feeding a tumor specific agent is administered (e.g., the hemostatic sponge pieces or metal spiral), which overlaps the vessel lumen.

Puncture sclerosing hemangioma is conducted under the supervision of the ultrasonic beam by a puncture hematoma and introducing it sclerosing (zapustevanie vessels causing) substance, usually 96% alcohol.

Hemangioma of the liver - it is a common disease, it is almost always asymptomatic and rarely require treatment.

Galina Romanenko

When carcinoid tumor Carcinoid tumors: the essence of the disease   spreads to other organs, surgery is not possible. But there are other treatments that can be used to deal with neuroendocrine tumors. Although these methods do not give a complete recovery from cancer, they can slow down or stop the growth of the tumor and relieve symptoms.

Treatment of carcinoids by various methods

Depending on the location of the tumor and on how far it is far it has spread, the doctor can use it for treating a variety of means. Even if the surgical treatment is impossible, it is possible to conduct an operation to remove a portion of the tumor. This procedure is called debulking.

In the treatment of carcinoid tumors are the most effective methods of aggression. Quite often using multiple treatments at a time. For example, first cytoreductive surgery followed by radiation then chemotherapy Chemotherapy - it always falls the hair? . This helps to slow tumor growth.

Medications that slow tumor growth

Drugs can prevent the rapid development of tumor and alleviate symptoms of carcinoid syndrome. Carcinoid syndrome - a condition accompanied by a set of symptoms, including flushing, wheezing, and diarrhea, and which takes place in the case when the tumor produces excessive amounts of hormones, such as serotonin and histamine.

• Octreotide. It is often used to treat carcinoids Octreotide (Sandostatin). Prelate in its composition is close to the hormones that are naturally produced in the human body. Octreotide helps to reduce redness and diarrhea caused by carcinoid syndrome Carcinoid syndrome: how to get rid of in the early stages And also slows tumor growth.
• Interferons. Interferon helps reduce the intensity of symptoms of carcinoid syndrome and hinders the development of carcinoids. But interferon can cause severe side effects, so not all patients can be assigned such treatment.
• Antihistamines. Receiving antigistaminnyeh some drugs may relieve the symptoms of carcinoid syndrome, but they are not able to slow tumor growth.

Scientists continue to look for other means capable of slow or stop the growth of carcinoids. Currently, several drugs in clinical trials or are waiting for approval of the Office of the United States to monitor the quality of food and medicines. Therefore, it may in the future be more treatment options.

Ablation as a means of reducing the size of the tumor

Ablation - a procedure that allows you to destroy or reduce the carcinoid. In the tumor itself is administered a substance that kills the tumor cells. This procedure is often used when the tumor has spread to the liver. Surgical treatment for this is no longer possible because of the size, location or number of tumors. There are several types of ablation:

• Cryotherapy (cryosurgery). The tumor was injected liquid nitrogen, killing neoplastic cells by freezing them.
• Percutaneous ethanol injection. For the destruction of tumor cells using a concentrated alcohol solution.
• Radiofrequency ablation. For the destruction of the tumor using high-energy radio frequency.

Chemotherapy as a means of cell destruction carcinoids

To destroy cancer cells Chemotherapy uses special drugs. They were introduced by infection or taken orally. Sometimes doctors use any single drug, and sometimes a combination of several drugs. These treatment causes a number of side effects have been used drugs damage not only cancer but also healthy cells. The most common side effects include hair loss, constant fatigue, nausea and vomiting. Basically, after the end of treatment, the symptoms cease. Sometimes the intensity of side effects, especially such as nausea and vomiting can be controlled or to prevent their occurrence by medication.

Unfortunately, the method of chemotherapy is not always effective in treating carcinoids.

Generally, chemotherapy is used to treat only a few species carcinoids, for example, tumors of the thyroid gland The thyroid gland - is responsible for your hormones . In the treatment of other types of carcinoid tumors, this method is not so effective.

However, sometimes doctors recommend chemotherapy when the disease is accompanied by pronounced symptoms when the tumor has already spread to other organs or when other treatments have not given effect. This method helps to slow the growth or spread of the tumor.

Chemotherapy can be effective if the tumor has spread to the liver. Sometimes chemicals are introduced by injection directly into an artery carrying blood to the liver, which is subjected to powerful chemical influence. At the same time the remaining bodies not impeded. In some cases, the patient is also administered substance obstructive this artery. As a result, the tumor cells are no longer receive oxygen and nutrients and begin to die.