Diagnosis of Hepatic Hemangioma in a 35-Year-Old Female with an Incidental Liver Lesion Detected on Ultrasound Examination

Hepatic hemangiomas are the most prevalent benign lesions of the liver, often discovered incidentally during imaging for unrelated reasons. We report a case of a 35-year-old woman with an incidental liver lesion detected during a routine ultrasound. The lesion was diagnosed as a hepatic hemangioma based on imaging findings, including non-contrast CT, 99mTc-labeled red blood cell (RBC) SPECT/CT, and clinical assessment. Ultrasound revealed a well-defined hyperechoic lesion, consistent with a hemangioma, and noncontrast CT imaging showed a low-density lesion. 99mTc-RBC SPECT/CT demonstrated characteristic radiotracer uptake, supporting the diagnosis. The patient had no symptoms and no identifiable risk factors for liver disease. The patient did not use oral contraceptives, had an allergy to iodinated contrast agents, and had metallic implants incompatible with MRI. This case highlights the importance of recognizing the typical imaging features of hepatic hemangiomas, which include well-defined, hyperechoic lesions on ultrasound, low-density areas on non-contrast CT, and specific uptake patterns on SPECT/CT. These diagnostic tools are essential for distinguishing hepatic hemangiomas from other hepatic lesions, including hepatic adenomas, focal nodular hyperplasia, and malignant tumors. While most hepatic hemangiomas are asymptomatic and require no treatment, accurate diagnosis is crucial to avoid unnecessary interventions. This case demonstrates the value of multiple imaging techniques in ensuring correct diagnosis and guiding appropriate management.