The effect of bleomycin embolization on symptomatic improvement and hemangioma size among patients with giant liver hemangiomas

Nontarget Hemangioma Size Reduction after Bleomycin-Ethiodized Oil Embolization of Primary Hepatic Hemangioma

PURPOSE

To evaluate changes in nontarget hepatic hemangiomas, which are neither subjected to embolization nor targeted for treatment, following selective bleomycin-ethiodized oil transarterial chemoembolization (TACE) of a giant hepatic hemangioma.

MATERIALS AND METHODS

This single-center retrospective study included 24 patients with nontarget hepatic hemangiomas distinct from primary giant hemangiomas treated with selective bleomycin-ethiodized oil TACE between 2009 and 2022. The size and volume of the lesions were assessed using computed tomography (CT) scans obtained before treatment and at 6, 12, and 24 months.

RESULTS

A significant reduction in the size of nontarget lesions (n = 34) was observed during follow-up (P < .05). Eighteen of 34 lesions (53%) showed a reduction in volume of 50% or greater. Overall clinical success rate for the primary lesion, defined as a significant size reduction and symptom improvement, was 96%. Logistic regression analysis showed no statistically significant association between demographic or primary lesion variables and changes in nontarget lesions (P = .901). Spearman correlation analysis revealed no significant relationship between changes in primary and nontarget lesions (P > .05).

CONCLUSIONS

Bleomycin-ethiodized oil TACE of a giant hepatic hemangioma significantly reduced the size of nontarget hemangiomas. This may be related to systemic absorption of the chemotherapeutic agent, lymphatic dissemination, or an abscopal effect, although the exact mechanism remains unclear.