A liver hemangioma is the most common benign hepatic tumor, formed by malformed blood-filled vessels. Most lesions are small (<5 cm) and discovered incidentally during imaging for unrelated problems; they remain asymptomatic throughout life. Symptoms, when present, relate to large size, rapid growth, or complications such as thrombosis, bleeding, or pressure on neighboring structures.

1. Right-upper-quadrant discomfort
   Dull, persistent pain or fullness under the ribs is the usual complaint, often exacerbated after large meals or prolonged sitting .
2. Nausea, early satiety, bloating
   A bulky hemangioma can compress the stomach and duodenum, leading to rapid fullness, eructation, and occasional vomiting .
3. Poor appetite and weight loss
   Chronic discomfort and early satiety may reduce oral intake, resulting in mild cachexia over time.
4. Jaundice (rare)
   Obstruction of intra-hepatic bile ducts by a centrally located or pedunculated tumor can elevate conjugated bilirubin, producing scleral icterus and dark urine .
5. Acute pain with bleeding or rupture
   Sudden severe pain, hypotension, and anemia signify hemorrhage into the lesion or intraperitoneal rupture—an emergency requiring immediate care .
6. Fever and inflammatory markers
   Thrombosis within the hemangioma or secondary inflammation can cause low-grade fever and elevated C-reactive protein without infection.

Because most lesions remain stable, any new or worsening symptom in a patient with a known hemangioma should prompt repeat imaging to assess for enlargement or complications.