Benign Liver Masses

Diagnosing Benign Liver Masses

Relatively common in the liver, benign (noncancerous) liver masses or lesions may incidentally be detected on imaging studies, abnormal liver function tests, or during investigation of abdominal pain.

Symptoms of benign liver masses

Hemangiomas

• Pain often occurs in lesions greater than 5 to 6 centimeters in size

Hepatic adenomas

• Many people experience no symptoms
• Can be associated with birth control use

Focal nodular hyperplasia (FNH)

• Abdominal pain

Hepatic cysts (large)

• Abdominal pain or fullness
• A palpable mass

Testing for benign liver masses

Differentiating benign liver lesions from cancers can sometimes be done by radiologic imaging studies alone.

In addition to a physical exam, your doctor may order the following tests:

Imaging studies

Imaging studies, such as CT scans or abdominal ultrasounds, can show:

• The size and location of the lesion(s)
• Any blood clots in the major branches of the portal and hepatic veins
• Any enlarged lymph nodes
• Evidence of cirrhosis and its complications
• The vasculature structure surrounding the lesion

FNH lesions are usually well defined, with a typical “central scar” on CT scans.

Hepatic cysts can usually be differentiated from solid lesions by ultrasound or CT scans.

It's helpful to compare the size of the lesion to prior imaging studies (if they exist), to determine if the mass is growing. Follow-up imaging is important to ensure that the lesion is not enlarging.

Blood tests

Blood tests measure a complete blood cell count and assess how well your liver works. These include liver function tests, as well as tumor markers to evaluate your general health.

Biopsy

If the diagnosis is not clear, then often a liver biopsy is done to examine a sliver of the liver mass under the microscope. This outpatient procedure allows the liver pathologist t o determine the tissue diagnosis or if cancer cells are present.

Hemangiomas — Caution should be taken in ordering a liver biopsy if the suspected diagnosis is hemangioma, due to the risk of bleeding from the biopsy site, especially if the lesion is at the edge of the liver.

Benign Liver Mass Treatments

The UPMC Liver Cancer Center offers treatment for people with noncancerous liver masses or lesions, such as:

• Hemangiomas
• Hepatic adenomas
• Focal nodular hyperplasia (FNH)
• Hepatic cysts

Liver surgery (resection)

Depending on the size and location of the mass, and the general health of your liver, you may be a candidate for surgical removal of hemangiomas, adenomas, FNH, and hepatic cysts.

The main reasons for liver resection, either minimally invasive (laparoscopic) liver surgery or traditional (open) liver surgery, include:

• A benign liver mass that causes abdominal pain
• A diagnosis that is still in question after the evaluation

For hepatic adenomas, surgical removal is usually recommended because of the significant risk of spontaneous rupture with intraperitoneal bleeding and the risk of malignant transformation to a well-differentiated hepatocellular carcinoma (HCC).

For hepatic cysts, treatment depends on the nature of the cyst. Symptoms also are taken into consideration. Definitive treatment is surgery, although simple cysts can occasionally be managed by aspiration, with or without sclerotherapy.

UPMC’s liver surgeons are among the most experienced in the United States at minimally invasive liver surgery, which is performed through three or four small incisions in the abdomen.

We perform this technique, whenever possible, to reduce:

• Pain
• Scarring
• Length of hospital stay
• Recovery time

Therapies for benign liver masses

If your tumor is too large to be removed by surgery, the UPMC Liver Cancer Center offers innovative therapies, such as radiofrequency ablation, to:

• Help shrink the tumor by placing a probe through an incision in the body so tiny electrodes can destroy cancer cells with heat and surgery is possible
• Manage your liver disease and extend your life

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Learn more about liver cancer treatments at the UPMC Liver Cancer Center.