Simultaneous degenerative changes in 2 hepatic cavernous hemangiomas observed over 23 years of follow-up: A case report and review of the literature

A 54-year-old woman presented to our hospital with general fatigue and liver dysfunction. Following a comprehensive examination, liver dysfunction was attributed to primary biliary cholangitis and autoimmune hepatitis. Abdominal ultrasonography revealed hepatic cavernous hemangiomas measuring 57 and 41 mm, which gradually shrank to 25 mm and 16 mm over 23 years, and the contrast-enhanced computed tomography and magnetic resonance images changed, showing no typical imaging features of hepatic cavernous hemangiomas. These changes were consistent with degenerative processes, such as partial necrosis, fibrosis, and hyalinization, suggesting progression from hepatic cavernous hemangioma to hepatic sclerosed hemangioma. Hepatic cavernous hemangiomas may shrink in size and may change imaging patterns due to degenerative changes over a long-term period.