Unexpected newborns in the liver : hemangiomatosis onset after hepatic resection of a giant cavernous hemangioma

A 47-year old woman underwent liver magnetic resonance imaging (MRI). In 2002, during abdominal ultrasound (US), a 4-cm lesion in liver segment VII typical for hemangioma was incidentally discovered. The lesion did not show any dimensional or morphological changes until 2007. The woman had two pregnancies, in 2008 and 2010 and she was not followed up. In 2011, the woman underwent US due to the onset of abdominal discomfort, and the hemangioma was seen to be notably increased in size (13 cm). This diagnosis was confirmed by liver MRI performed in 2012. In 2013, the patient underwent surgical resection of the hepatic hemangioma which, due to its large dimensions, was probably responsible for the abdominal pain that disappeared after surgery. The final pathological diagnosis was a giant cavernous hemangioma without signs of hemangiomatosis. In 2018, the MRI showed multiple nodular lesions <1 cm, exclusively diffused in the residual right lobe, strong hyperintense on T2-weighted images and in the arterial phase , without wash-out of the contrast media in the portal-venous phases and hypointense in the hepatobiliary phase. Is it possible to reach a correct diagnosis without any previous imaging studies?