Hemangioma is the Most Common Benign Hepatic Lesion
The most common benign hepatic lesion is hemangioma (answer choice A). 1, 2, 3, 4, 5
Evidence Supporting Hemangioma as the Most Common Benign Liver Lesion
Hemangiomas, also referred to as cavernous hemangiomas, are definitively established as the most common benign mesenchymal hepatic tumors according to multiple authoritative sources:
- The American College of Radiology (ACR) recognizes hemangiomas as one of the common benign liver masses 1
- Praxis Medical Insights clearly states that the prevalence of hepatic hemangiomas in the general population is between 0.4% to 8% 2
- Multiple research studies consistently identify hemangiomas as "the most common benign hepatic tumors" 3, 5
Characteristics of Hepatic Hemangiomas
Hepatic hemangiomas have several distinctive features:
- They show a strong female predominance with a female:male ratio of up to 5:1 2
- Most are solitary, small lesions that are incidentally detected 3
- They typically present with characteristic imaging findings:
- High signal intensity on T2-weighted MRI images
- Peripheral nodular enhancement with progressive centripetal filling on contrast studies
- Early peripheral nodular enhancement with progressive centripetal filling on dynamic contrast sequences 2
Other Common Benign Hepatic Lesions
While hemangioma is the most common, other benign hepatic lesions include:
- Focal nodular hyperplasia (FNH) - typically solitary with a "central scar" of low attenuation 1
- Hepatic adenoma - less common than hemangiomas and FNH 1, 5
- Simple cysts 1
- Fatty infiltration 1
Management Considerations
Most hepatic hemangiomas require no intervention:
- Asymptomatic hemangiomas should be managed conservatively regardless of size 2
- Observation without specific intervention is recommended as the standard management approach for benign liver hemangiomas <5 cm 2
- Intervention should be considered only for:
- Symptomatic lesions
- Progressive enlargement
- High-risk features
- Size >10 cm with symptoms 2
Important Clinical Considerations
- Liver biopsy should be avoided if imaging strongly suggests hemangiomas due to the risk of bleeding 2
- Regular clinical follow-up is recommended, with imaging frequency based on hemangioma size:
- Annual ultrasound for medium-sized hemangiomas (5-10 cm)
- Ultrasound every 6 months for giant hemangiomas (>10 cm) 2
- Special monitoring is needed during pregnancy for hemangiomas >5 cm 2
In conclusion, the evidence clearly establishes hemangioma as the most common benign hepatic lesion, with focal nodular hyperplasia and hepatic adenoma being less common alternatives.