The Effect of Bleomycin Embolization on Symptomatic Improvement and Hemangioma Size among Patients with Giant Liver Hemangiomas

Objective: The optimal treatment of giant liver hemangiomas is controversial. Although surgery is the usual treatment for symptomatic giant hemangiomas, minimally invasive techniques have been recently recommended as an alternative therapy. Aim: we aimed to assess the effect of bleomycin embolization with lipiodol on symptomatic improvement and hemangioma size among patients with symptomatic giant liver hemangiomas. Methods: This study retrospectively involved 17 patients [10 women, 7 men; Age range 35 - 67 years (mean 46.41 ± 2.6 years)] with giant liver hemangioma who presented to our clinic between August 2014 and October 2016. Bleomycin mixed with lipiodol was administered using selective arterial embolization. The patients were followed by clinical, laboratory, ultrasonography and abdominal tomographic examination (mean 14.47 ± 2.21 months). All statistical analyses were performed using SPSS 15.0; a p value of less than 0.05 was considered statistically significant. Results: The mean volume of hemangiomas was 1799.3 cm3 (range 480 - 9925.1 cm3) before the procedure and 405.7 cm3 (range 38.7 - 3856 cm3) after the procedure. No treatment-related death was observed. All patients demonstrated symptomatic improvement and significant volume reduction (p = 0.001). Conclusions: Minimally invasive bleomycin embolization is an effective alternative to surgery for patients with giant liver hemangiomas.