Benign Liver Mass

There are several types of liver tumors that are generally benign. They are found mostly by image studies for other reasons. The common ones are:

Hemangioma

Hemangioma is the most common benign solid tumor of the liver. It varies a lot in size, ranging from less than a centimeter to 20 centimeters. Hemangioma contains fibrous tissue and small blood vessels. Patients with hemangioma usually have no symptoms. Large hemangioma may cause abdominal pain, discomfort, fullbess, etc. Rarely this type of tumor can rupture and cause bleeding in the belly.

Hepatic adenoma

Hepatic adenoma usually is a benign solid tumor in the liver. It is commonly found in young women. This type of tumor ranges in size from 1 to 30 centimeters. Oral contraceptives, anabolic androgens, glycogen storage disease, etc, are known factors that strongly associated with hepatic adenoma. Most of the hepatic adenomas do not produce symptoms. Larger ones usually cause abdominal distention and pain. Although, hepatic adenoma is considered as a benign lesion, it carries significant risk of spontaneous rupture causing bleeding in the belly and risk of developing cancer.

Focal nodular hyperplasia (FNH)

FNH is a benign solid mass in the liver. Like hepatic adenoma, it is usually occurs in women of childbearing age. FNH is most likely related to some hormones at certain age. Its link to oral contraceptive use is not as clear as hepatic adenoma. In different to hepatic adenoma, FNH has no risk of cancer and rupture/bleeding is very rare.

Liver cysts

Hepatic cysts are fluid-filled sacs in the liver. There are several types of liver cysts: simple liver cysts, biliary cysts, infectious cysts, cystadenomas etc. Although small, some cysts do carry some risks of cancer.

Symptoms and Signs

Most patients have no symptoms. If the tumor is big, it may have:

  • Abdominal discomfort or pain
  • Fullness
  • Nausea
  • Vomiting
  • Jaundice

If the tumor ruptures, it may cause abdominal pain, weakness, low blood pressure, etc, which needs emergent treatment.

Diagnosis and Treatment

Most of these tumors are found by by image studies for other reasons. Typical features shown on radiological images, such as CT or MRI, are usually able to diagnosis of these tumor. If uncertain, a liver biopsy will help make the diagnosis. One or more of the following tests maybe needed.

  • Blood works
  • Abdominal ultrasound with Doppler
  • CT scan
  • MRI/MRCP
  • Liver biopsy
  • EUS

Treatment is based on the type and size of the tumor. For example, small FNH that does not cause any damage is usually leave alone. Bigger adenoma usually needs surgery resection.

References:

  1. PubMed Health.
  2. Wikipedia.
  3. Mayo clinic online health information.
  4. Sleisenger and Fordtran's Gastrointestinal and Liver Disease- by Mark Feldman MD, et al.
  5. The Little Black Book of Gastroenterology-by David W. Hay.
  6. Principles of Clinical Gastroenterology by Tadataka Yamada, et al.


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