Benign liver neoplasms
-Cavernous hemangiomas, focal nodular hyperplasia, hepatic adenomas are the most common benign tumors of the liver.
-Cavernous hemangioma: The most common benign neoplasm of the liver; more than 80% occur in women
-Focal nodular hyperplasia: second most common after cavernous hemangiomas; occurs at all ages
-Hepatocellular adenoma occurs most commonly in women aged 20-40; usually caused by oral contraceptives
Symptoms & Signs
Most benign neoplasms are aymptomatic; Palpable abdominal mass, bleeding, nausea, vomiting, early satiety
Cavernous hemangioma: Ultrasound, CT, MRI
FNH: lesions are identified by the presence of a central scar; CT, Ultrasound shows
Hepatic adenoma: Ultrasound show hyperechoic mass; Hepatic angiography is the most valuable diagnostic tool.
Cavernous hemangioma: if symptomatic, surgical resection
Focal nodular hyperplasia & OCPs: no need to discontinue OCPs; annual ultrasonography for 2-3 years; if symptomatic, resection
Hepatocellular adenoma: resection, percutaneous radiofrequency ablation
-Resection is advised in all patients in whom the tumor causes symptoms or measures > 5 cm in diameter, even in the absence of symptoms
-Resection is also recommended even for an adenoma measuring < 5 cm in diameter if a beta-catenin gene mutation is present in a biopsy sample