Introduction: Hemangiomas are the most common benign tumor of the liver with an estimated prevalence of 0.4% to 20%. They are usually smaller than 4 cm in diameter and remain asymptomatic. Those with a diameter more than 5 cm are termed giant hemangioma. Here we present a case of giant hepatic hemangioma that causes liver failure and cured by liver transplantation.

Case Report: Six years ago, a 57 year old woman was referred to the hospital because of a history of abdominal distention. The physical examination of the woman revealed a mass with the diameter of 17 cm that was extending through the abdominal region. This tumor was diagnosed as giant hemanjioma with the abdominal ultrasonography (USG) and computed tomography. She was treated with chemoembolution at that time. Ten months after chemoembolution, she was admitted to our hospital for second opinion. Abdominal USG revealed liver hemangioma which was occupying the left lobule and was found to increased in size (21 cm in diameter). Laparatomy was performed for the resection of the hemangioma, but during the laparotomy, intraoperative biyopsy revealed a cirrhotic prossess in the non-tumoral liver paranchyma. Thus the operation was ended without the resection of the tumor. After two years, liver transplantation was performed to patient from living related donor. Tacrolimus based regimen was started as an immunosupressive therapy. Five years after liver transplantation the patient is doing well without allograft failure.

Conclusions: A liver hemangioma is a benign, usually small tumor comprised of blood vessels, which is often discovered coincidentally and do not require treatment. However, giant hemangiomas may give rise to symptoms requiring treatment such as interferon, radiation, arterial embolization, surgical resection or rarely liver transplantation. Here we report a rare case of giant hemangioma, occupying almost all the liver paranchyme and cured by liver transplantation.