Differential Diagnosis for Liver Mass
- Single Most Likely Diagnosis
- Hepatocellular carcinoma (HCC): This is the most common primary liver cancer, especially in patients with risk factors such as hepatitis B or C infection, alcohol abuse, or cirrhosis. The presence of a liver mass in a patient with these risk factors makes HCC a leading consideration.
- Other Likely Diagnoses
- Metastatic liver disease: Given that the liver is a common site for metastasis from various cancers (e.g., colorectal, breast, lung), a liver mass could represent metastatic disease, especially in patients with a known history of cancer.
- Hemangioma: This is the most common benign liver tumor, often found incidentally on imaging. While usually asymptomatic and requiring no treatment, large hemangiomas can cause symptoms due to their size or location.
- Focal nodular hyperplasia (FNH): Another benign condition, FNH is a tumor-like condition that can appear as a mass on imaging. It is more common in women and is usually asymptomatic.
- Do Not Miss Diagnoses
- Hepatic adenoma: Although rare, hepatic adenomas can rupture and cause severe bleeding, making them a critical diagnosis not to miss, especially in young women using oral contraceptives.
- Intrahepatic cholangiocarcinoma: A malignancy of the bile ducts within the liver, this diagnosis is important to consider due to its aggressive nature and poor prognosis if not treated early.
- Rare Diagnoses
- Hepatoblastoma: A rare malignant liver tumor, primarily affecting children, making it an important consideration in pediatric patients presenting with a liver mass.
- Angiosarcoma: A rare and aggressive malignancy of the blood vessels within the liver, often associated with exposure to certain chemicals like vinyl chloride or thorotrast.
- Biliary cystadenoma/cystadenocarcinoma: Rare, benign or malignant tumors of the bile ducts that can present as a liver mass, often with a cystic appearance on imaging.