Diagnosis and surgical decision-making in hepatic hemangioma: From venous malformation overlap to artificial intelligence-assisted multimodality imaging

Table 1 Terminology and entity distinctions relevant to a diagnosis-focused review of hepatic hemangioma

Entity	Typical setting	Key diagnostic clue	Management implication
Adult hepatic hemangioma (routine radiology term)	Incidental lesion in adults; usually asymptomatic	Marked T2 hyperintensity and progressive nodular fill-in on dynamic imaging	Most lesions can be observed; biopsy is usually unnecessary when imaging is classic
Hepatic venous malformation (vascular anomaly framing of many adult ‘cavernous hemangiomas’)	Symptomatic or giant adult lesion; slow-flow ectatic vascular spaces	Overlap of imaging/pathology with adult HH; recent GJA4-linked studies support VM biology	Introduces percutaneous sclerotherapy and vascular-anomaly-based terminology into management discussions
Infantile hepatic hemangioma	Infancy; may be focal, multifocal, or diffuse	Biologically proliferative vascular tumor with pediatric presentation	Different natural history and treatment pathway from adult incidental HH
Sclerosed/hyalinized hemangioma	Older or involuted lesion; often atypical imaging	Reduced T2 brightness, incomplete fill-in, retraction or rim-like enhancement	Major mimic of malignancy; often drives escalation to MDT review or surgery if unresolved.

HH: Hepatic hemangioma; VM: Venous malformation; MDT: Multi-disciplinary team.