A 48-year-old woman undergoes ultrasound for vague epigastric pain. A well-defined hyperechoic lesion with posterior acoustic enhancement is seen in segment VII. Contrast MRI confirms a cavernous hemangioma. What is the most appropriate next step?

• A Ultrasound-guided core biopsy to confirm the diagnosis
• B Transarterial embolization as first-line therapy
• C Segmental hepatic resection to prevent hemorrhage
• D Observation with no treatment, as these lesions rarely rupture or undergo malignant change ✓

Explanation

Asymptomatic cavernous hemangiomas require only observation; they do not rupture spontaneously except rarely, and they have no malignant potential. Percutaneous biopsy is specifically avoided because of the risk of torrential hemorrhage from this vascular lesion, which kills option A. Resection and embolization are reserved for rapidly enlarging or severely symptomatic lesions.

Reference: Schwartz's Principles of Surgery, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.