Diagnosis

Benign liver tumor

A benign focal lesion of the liver.

Also known as: Focal nodular hyperplasia, Hepatic hemangioma, Hepatic mesenchymal hamartoma, Hepatocellular adenoma, Liver hemangioma

Etiology

Cause [1za]

Pathophysiology [1za]

  1. Hepatic hemangioma: not related to contraception

  2. Hepatocellular adenoma:

    • Usually in women (20–50 years) who have taken estrogen-based contraception

    • Complication: tumor bleeding or malignant transformation to HCC

Epidemiology

Incidence per 100.000 [hvc][hum]

Epidemiology chart for Incidence

Prevalence per 100.000 [hvc][hum]

Epidemiology chart for Prevalence

Symptoms & findings

Symptoms

Hepatomegaly

Clinical findings

None listed.

Anamneses

None listed.

Localized findings

Pain
Radiates
RUQ (Right Upper Quadrant)
Onset
Gradual (days)
Pattern
Constant
Severity
Mild (1-3)
Swelling
Radiates
RUQ (Right Upper Quadrant)
Onset
Gradual (days)
Pattern
Constant

Approach

Treatment

  1. Usually incidental finding/asymptomatic patient

  2. Treatment if compression, rupture or heart failure:

    • Radiofrequency ablation (RFA)

    • Hepatic irradiation

    • Arterial embolization

    • Liver resection − including hypertrophy concepts like preoperative portal vein embolization, enucleation, hepatic artery ligation

    • Liver transplantation

Differential diagnoses

Cholangiocarcinoma, Hepatocellular carcinoma

References

[1] Nault JC, Paradis V, Ronot M, Zucman-Rossi J. Benign liver tumours: understanding molecular physiology to adapt clinical management. Nat Rev Gastroenterol Hepatol. 2022 Nov;19(11):703-716.

[2] Kinyas Kartal, Erhan Hamaloglu. Review Article: Benign tumors of the liver. Int J Clin Exp Med 2016;9(2):596-605.

[3] Oldhafer et al. Benign Liver Tumors. Visc Med. 2020 Aug;36(4):292-303.

[4] Karhunen PJ. Benign hepatic tumours and tumour like conditions in men. J Clin Pathol. 1986 Feb;39(2):183-8.

[5] White, R.R., Menon, V.G. (2020). Benign and Malignant Tumors of the Liver. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, Cham.

[6] Xiaolei Liuet al. Patient age affects the growth of liver haemangioma. HPB, Volume 20, Issue 1, 2018, Pages 64-68.

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