From the Guidelines
Liver benign tumors are non-cancerous growths that develop in the liver tissue, with the most common types including hemangiomas, focal nodular hyperplasia (FNH), hepatic adenomas, and simple liver cysts, as reported in the most recent study 1. These tumors are typically discovered incidentally during imaging tests performed for other reasons, as most don't cause symptoms. When symptoms do occur, they may include:
- Abdominal pain
- A feeling of fullness
- A palpable mass in the upper right abdomen Most benign liver tumors don't require treatment unless they cause symptoms or there's concern about potential complications. For symptomatic tumors, treatment options include:
- Surgical removal
- Embolization (blocking blood supply to the tumor)
- Radiofrequency ablation Hepatic adenomas specifically may require closer monitoring or removal due to their small risk of bleeding or malignant transformation, especially in women taking oral contraceptives, as noted in 1. Regular follow-up imaging may be recommended to monitor the size and characteristics of benign liver tumors, with a study from 1 suggesting that the use of CHC or pregnancy is considered safe with no monitoring required for hepatic hemangiomas. However, another study from 1 recommends close monitoring for haemangiomas during pregnancy, especially for larger lesions. These tumors develop due to abnormal cell growth but lack the ability to invade surrounding tissues or spread to other parts of the body, distinguishing them from malignant liver tumors. It's essential to prioritize the management of these tumors based on the most recent and highest-quality evidence, such as the study from 1, to ensure the best possible outcomes in terms of morbidity, mortality, and quality of life.
From the Research
Definition and Types of Liver Benign Tumors
- Liver benign tumors are a group of non-cancerous growths that occur in the liver, with the most common types being hemangioma, focal nodular hyperplasia (FNH), and hepatocellular adenoma (HCA) 2, 3, 4.
- These tumors can be solid or cystic, and may be hepatocellular, biliary, or stromal in nature 5.
- Hemangioma is the most common benign solid liver tumor, followed by focal nodular hyperplasia, while simple cysts are the most common cystic tumors 4.
Clinical Presentations and Diagnosis
- Most patients with benign liver tumors are asymptomatic, and the tumors are often discovered incidentally on imaging tests performed for other reasons 2, 4.
- Advanced imaging techniques, such as ultrasonography, can provide accurate diagnosis in most cases, reducing the need for biopsies 2.
- The clinical context, including sex, age, and use of oral contraceptives, is important for diagnosis, particularly for distinguishing between focal nodular hyperplasia and hepatocellular adenoma 6.
Complications and Treatment
- The two most serious complications of benign liver tumors are bleeding and malignant transformation 2.
- Treatment options for hemangiomas include liver resection, radiofrequency ablation, and transarterial catheter embolization, and should be carefully weighed against possible complications 2.
- Focal nodular hyperplasia is generally not associated with malignant transformation, and treatment is only necessary for symptomatic patients 2.
- Hepatocellular adenoma is associated with the use of oral contraceptives or other steroid medications, and may be complicated by malignant transformation 2, 6.