A case of spontaneous hepatic hemangioma rupture: Successful management with transarterial chemoembolization alone

Hemangioma is the most common benign hepatic tumor. Although spontaneous rupture is rare, the mortality rate ranges from 60 to 75%. Only 34 cases have been reported in the literature, with only one report using transcatheter arterial embolization (TAE) alone as treatment. We report a case of spontaneous rupture with “flowering sign” of a giant hepatic hemangioma, presenting with acute abdominal pain and shock, while the volume of the hemangioma and blood loss were similar. The patient was successfully managed by transarterial chemoembolization (TACE) alone, which has an operative mortality rate of up to 36.4%. Keywords: Hepatic hemangioma, Spontaneous rupture, Transarterial chemoembolization, Flowering sign