Munich Re’s medical experts respond to challenging underwriting scenarios
This series presents individual medical cases that feature challenging conditions, uncommon diseases, or an unusual presentation of symptoms. Below we summarize a case, explain our research and analysis, and suggest an underwriting recommendation. Munich Re’s team of global medical directors routinely conducts rigorous analyses of the latest medical advances so that primary insurers and society alike can benefit from evidence-informed risk assessments. It is our hope that exploring compelling cases will foster a greater understanding of medical research and awareness of new medical innovations and emerging risks while ultimately expanding insurability.
Case: Liver hemangiomas
Munich Re medical's response
- A hemangioma is a cluster of blood vessels that resembles a mass. Often considered a congenital anomaly, it can occur anywhere in the body but is frequently seen on the skin. When located in the liver, it is referred to as a liver hemangioma, hepatic hemangioma, or cavernous hemangioma.
Hemangiomas are the most common benign tumor of the liver, seen in up to 20% of the general population.1 With the increase in abdominal imaging such as CT scans, MRIs, and ultrasounds, many more are being discovered incidentally when a person has no symptoms. Most are asymptomatic with excellent prognosis, although a few may have symptoms such as pain. Liver hemangiomas are often solitary, but sometimes multiple lesions are present. The majority are followed by serial imaging, with surgical resection being rare.
Bleeding from a rupture of blood vessels is rare, but can occur. Once hepatic cellular carcinoma is ruled out, the overall prognosis for most patients is excellent, as the majority remain asymptomatic with stable lesions. Size is an important prognostic factor along with stability on surveillance imaging.