Hormone replacement, oral contraceptives and pregnancy may contribute to growth of hepatic hemangiomas; however, the lesions are negative for estrogen and progesterone receptors (Visc Med 2020;36:292, World J Gastroenterol 2020;26:11)

Hepatic hemangioma: abdominal distension and discomfort when more than 5 cm in size; most are asymptomatic (J Hepatobiliary Pancreat Sci 2017;24:417) Skeletal: mostly asymptomatic; rarely present with localized symptoms, such as bone pain and pathological fracture ( BMC Musculoskelet Disord 2021;22:27 )

Giant liver hemangioma is defined as hemangioma with a diameter of more than 5cm. This unique and uncommon type of haemangioma usually poses therapeutic challenges for the treating physician, especially hepatic surgeons, due to the unclear natural history, and due to the risk of life threatening complications is yet to be established.

Gross Pathology - Cavernous Hemangiomas of Liver: They are larger, usually solitary, reddish-brown, well-circumscribed, unencapsulated masses with a honeycombed surface. Some may be pedunculated. The location may be subcapsular (more common) or deep parenchymal. Lesions larger than 5 cm are arbitrarily referred to as giant cavernous hemangiomas.

Hepatic hemangiomas, representing the predominant benign mesenchymal neoplasms of the hepatic tissue, frequently manifest as asymptomatic entities, identified serendipitously through imaging modalities conducted for unrelated reasons, and seldom compromise hepatic functionality.