An enigmatic abdominal mass presenting 1 year after childbirth
Antonio Cubisino1
, Jules Grégory2, Aurélie Beaufrère3
Submitted Mar 12, 2025. Accepted for publication Apr 25, 2025. Published online May 23, 2025.
doi: 10.21037/hbsn-2025-156
A 31-year-old woman presented with a 4-week history of abdominal bloating and pain, occurring one year after an uncomplicated vaginal delivery. Laboratory tests revealed normal liver function with an elevated cancer antigen 19-9 (CA19-9) level (56.3 KU/L; normal <37 KU/L). Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) identified a large (22 cm × 14 cm) heterogeneous solid-cystic lesion (red arrows) in the right liver (Figure 1A,1B).
Given the symptomatic presentation, strong imaging-based suspicion of sarcomatoid malignancy, and confirmed resectability, a right hepatectomy was performed rather than a diagnostic biopsy, to minimize the risk of tumor seeding or hemorrhage and to expedite definitive treatment (Figure 1C,1D). Histopathological examination revealed a sclerosing hepatic hemangioma (Figure 1E,1F).
Hepatic haemangiomas are benign, often incidentally discovered vascular tumors of the liver that arise from developmental alterations in vasculogenesis. Although most hepatic haemangiomas remain asymptomatic and stable, some may appear or significantly enlarge over time, particularly with estrogen use or during pregnancy, necessitating surgical resection for symptomatic lesions, diagnostic uncertainty, or to prevent complications such as rupture or coagulopathy (1-5).
In this patient’s case, the lesion was not detected during the routine echographic controls in pregnancy, and it likely grew or significantly enlarged afterward, highlighting a link between hormonal changes and hemangioma progression.
Acknowledgments
None.
Footnote
Provenance and Peer Review: This article was a standard submission to the journal. The article has undergone external peer review.
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Funding: None.
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://hbsn.amegroups.com/article/view/10.21037/hbsn-2025-156/coif). The authors have no conflicts of interest to declare.
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