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CURRENT Medical Diagnosis & Treatment 2013
Benign Liver Neoplasms
Sections: Clinical Findings, Treatment, When to Refer, When to Admit.
Topics Discussed: benign neoplasm of liver; bile duct diseases; focal nodular hyperplasia; hemangioma of liver; hepatic adenoma; liver cell adenoma; liver diseases; oral contraceptives; pancreatic diseases.
Excerpt:"
Benign neoplasms of the liver must be distinguished from hepatocellular carcinoma and metastases (see Chapter 39: Cancer). The most common benign neoplasm of the liver is the cavernous hemangioma, often an incidental finding on ultrasonography or CT (see eFigure 16–44). This lesion may enlarge in women who take hormonal therapy and must be differentiated from other space-occupying intrahepatic lesions, usually by contrast-enhanced MRI, CT (eFigure 16–45), or ultrasonography. Rarely, fine-needle biopsy is necessary to differentiate these lesions and does not appear to carry an increased risk of bleeding. Surgical resection of cavernous hemangiomas is rarely necessary but may be required for abdominal pain or rapid enlargement, to exclude malignancy, or to treat Kasabach-Merritt syndrome (consumptive coagulopathy complicating a hemangioma).The only physical finding in focal nodular hyperplasia or hepatocellular adenoma is a palpable abdominal mass in a minority of cases. Liver function is usually normal. Arterial phase helical CT and MRI with contrast can distinguish an adenoma from focal nodular hyperplasia in 80–90% of cases and may suggest a specific subtype of adenoma (eg, homogeneous fat pattern in HNF1alpha-mutated adenomas..."
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