Although hemangioma of infancy (HOI) is the most common benign tumor of childhood, occurring most frequently in the head and neck region and involving the skin, hepatic hemangioma in the pediatric age group is rare. However, when present, the pathologic and radiologic features of this lesion are similar to those of adult liver he-mangioma (see Chapt. 4, "Imaging of Benign Focal Liver Lesions", section 4.1.1, "Hepatic Hemangioma"). The most important differential diagnoses in this context are angiosarcoma and IHE of the liver.

Whereas solitary hepatic hemangioma in the pediatric age group is a rare occurrence, multiple hemangiomas in the context of viscerocutaneous hemangiomatosis (Fig. 5) may be found in the liver. Multifocal cutaneous hemangiomas (generally defined as five or more) have a "localized" type of morphology and a well-recognized potential for concomitant visceral hemangiomas. The term "disseminated neonatal hemangiomatosis" has been used to describe this uncommon presentation of several hundreds of small, multifocal heman-giomas of the skin in association with extracuta-neous, most commonly hepatic hemangiomas [35].

Hepatic hemangiomas in this context may manifest with coagulopathy, heart failure, and/or respiratory distress. Internal hemorrhage is also of significant concern with hemangiomas in hepatic or gastrointestinal locations. Often patients become symptomatic shortly after birth. Therapeutic options for hepatic and gastrointestinal heman-giomas may include surgical resection, emboliza-tion, corticosteroids, and interferon-a [8]. Imaging findings are similar to the findings in adults, although rapid filling is more common in the pedi-atric forms (Fig. 5).

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