Benign Liver Tumors

Abstract

Background: Due to the frequent use of medical imaging including ultrasonography, the incidence of benign liver tumors has increased. There is a large variety of different solid benign liver tumors, of which hemangioma, focal nodular hyperplasia (FNH), and hepatocellular adenoma (HCA) are the most frequent. Advanced imaging techniques allow precise diagnosis in most of the patients, which reduces the need for biopsies only to limited cases. Patients with benign liver tumors are mostly asymptomatic and do not need any kind of treatment. Symptoms can be abdominal pain and pressure effects on adjacent structures. The 2 most serious complications are bleeding and malignant transformation. Summary: This review focuses on hepatic hemangioma (HH), FNH, and HCA, and provides an overview on clinical presentations, surgical and interventional treatment, as well as conservative management. Treatment options for HHs, if indicated, include liver resection, radiofrequency ablation, and transarterial catheter embolization, and should be carefully weighed against possible complications. FNH is the most frequent benign liver tumor without any risk of malignant transformation, and treatment should only be restricted to symptomatic patients. HCA is associated with the use of oral contraceptives or other steroid medications. Unlike other benign liver tumors, HCA may be complicated by malignant transformation. HCAs have been divided into 6 subtypes based on molecular and pathological features with different risk of complication. Key Message: The vast majority of benign liver tumors remain asymptomatic, do not increase in size, and rarely need treatment. Biopsies are usually not needed as accurate diagnosis can be obtained using modern imaging techniques.

Differential Diagnosis of Clinical, Imaging and Pathological Features Between Focal Nodular Hyperplasia and Hepatocellular Carcinoma

“…Most patients were found through physical examination, and a few patients had a history of oral contraceptives and no background of hepatitis or cirrhosis. However, there were more males than females in this study, which was inconsistent with the literature reports [17], which may be related to the small sample size. HCC is more common in middle-aged and elderly men with acute onset, abdominal pain, and background of hepatitis or cirrhosis, which is similar to that reported in the literature [18][19][20].…”

Case Report: Ultrasound-Guided Percutaneous Microwave Ablation of Focal Nodular Hyperplasia in a 9-Year-Old Girl

“…To date, there are no clear guidelines for the treatment of FNH. In general, the stability of the lesion and its benignity can be evaluated by 6 months of follow-up ( 12 ). As the lesion in this case displayed evident enlargement within 6 months and the parents were concerned that it might continue to grow and cause symptoms, continued observation was not appropriate.…”

Hepatic Adenomatosis in Aicardi Syndrome: a Clinical Report and Review of the Literature

“…These rare benign liver tumors arise in noncirrhotic liver; thery occur predominantly in young women who take oral contraceptives or other steroid medications [8]; the annual incidence is 3 per 100,000 in women who have used oral contraceptives over years [9]. A small part of of patients have multiple lesions; >3 lesions is de ned liver adenomatosis [8]. Its development is associated with some genetic syndromes, in particular glycogen storage diseases [10].…”