Coexisting Hepatic Hemangioma Treated Incidentally with Percutaneous Ethanol Injection and Transarterial Chemoembolization in a Case of Hepatocellular Carcinoma

Hepatic hemangiomas are not routinely treated except for large symptomatic lesions. Trans-arterial chemo-embolization (TACE) and percutaneous ethanol injection (PEI) are often used to treat hepatocellular carcinoma (HCC). We report a patient with underlying HCC and a coexisting small hemangioma that was inadvertently treated with both PEI and TACE because of misdiagnosis as an additional HCC. The hemangioma persisted with no visible imaging changes, nor complications. It is important to identify hemangiomas in HCC patients to avoid unnecessary treatment.