How Fast Do Liver Hemangiomas Grow, Shrink, or Stay Stable?

Liver hemangiomas are common, benign (non-cancerous) tangles of blood vessels. While they are often stable, it is entirely normal for them to slowly change in size over time. When followed with serial imaging, many liver hemangiomas remain stable, some grow slowly, and others actually decrease in size ^[1][2].

If a follow-up scan shows that a typical, definitively diagnosed hemangioma has grown, this is usually just part of its natural behavior ^[1][3]. A true hemangioma does not transform into liver cancer.

How Often Do They Grow, Shrink, or Stay the Same?

The likelihood of a hemangioma changing in size depends heavily on the study length and how researchers defined a “meaningful” change. The numbers below are study averages, not a prediction of exactly what your hemangioma will do.

• When tracking any measurable change: In a four-year study, 61% of hemangiomas showed some growth, 23.7% remained perfectly stable, and 8.5% shrank ^[1].
• When tracking meaningful change (greater than 20%): A long-term study (median follow-up of nearly 7 years) found that nearly half (47.5%) of hemangiomas remained stable. About 32% enlarged by more than 20%, and 21% decreased in size by more than 20% ^[2]. Among giant hemangiomas (often defined as larger than 10 cm), half showed no change over an eight-year period ^[3].

How Fast Do They Grow?

When liver hemangiomas do grow, the rate is generally very slow. Studies suggest an average growth rate ranging from 1.4 millimeters to 2.5 millimeters per year ^[4][3].

A note on measurement variability: A difference of 1 or 2 millimeters between two scans might not be true growth. Different machines, different scanning techniques (like ultrasound versus MRI), or even the radiologist measuring the lesion from a slightly different angle can produce small variations.

However, studies show that average growth rates can be influenced by:

• Age: Younger patients tend to experience faster hemangioma growth. One study found that patients under age 30 had an average growth rate of 4.6 mm per year, which slowed down to 2.1 mm per year for patients over 50 ^[1].
• Initial Size: In one study, lesions between 8 cm and 10 cm had the highest average growth rate (8.0 mm per year). By contrast, very small lesions under 2 cm averaged only 1.6 mm of growth per year ^[1].

Can They Shrink?

Yes. Long-term research indicates that roughly 21% to 23% of hemangiomas eventually decrease in size by more than 20% ^[2][3]. In another large review, spontaneous regression was documented in 6.4% of patients, and interestingly, some of these lesions had actually enlarged before they started to shrink ^[5].

In patients with cirrhosis, hemangiomas may develop sclerotic (scar-like) changes and shrink ^[6]. Important warning: People with cirrhosis are at a higher risk for liver cancer. Any changing or new spot on a cirrhotic liver must be carefully evaluated by a specialist to ensure it is actually a benign hemangioma and not cancer.

Does Growth Mean It Is Cancer?

A definitively diagnosed hemangioma is benign and does not turn into cancer ^[7]. True interval growth is frequently observed in benign hepatic hemangiomas ^[1][3].

If an enlarging lesion is later found to be cancer, it is typically because the original imaging was unclear or the diagnosis was uncertain from the start—not because the hemangioma changed into cancer ^[7][8].

Do I Need Ongoing Scans?

For small, asymptomatic hemangiomas that have been confidently diagnosed as “typical” on high-quality imaging, clinical guidelines generally state that no further routine imaging follow-up is required ^[9].

Your doctor may recommend ongoing surveillance or further specialized imaging (like a multiphasic CT or MRI) if:

• The initial diagnosis was unclear or the lesion has “atypical” imaging features ^[10][8][11].
• You have underlying chronic liver disease, such as cirrhosis or hepatitis B ^[12].
• You have a known history of cancer elsewhere in the body ^[13].
• The lesion is extremely large or begins causing severe symptoms ^[14].

While mild abdominal pain or early fullness can occur, these symptoms are non-specific and are often unrelated to the hemangioma itself. However, if you experience sudden severe abdominal pain, fainting, marked weakness, or dizziness, seek urgent medical evaluation, as these could be signs of a rare complication like internal bleeding ^[14].