Benign (noncancerous) liver masses, growths, or lesions are relatively common. These masses can be harmless depending on their size and location, but their existence can be stress-inducing. There are several different types of masses and solutions to remove them.
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What Is a Benign Liver Mass?
A benign liver mass is a noncancerous growth that can occur in the liver for multiple reasons. These growths are often found on imaging scans, through an abnormal liver function test result, or during investigation of abdominal pain. These masses are usually harmless, but if they grow large enough, they can impede liver function and cause abdominal pain.
What are the types of benign liver masses?
The types of benign liver masses include:
Hemangiomas (also called hemangiomatas)
- The most common benign solid lesions of the liver.
- Represent congenital vascular lesions that contain fibrous tissue and small blood vessels that eventually grow.
- Range in size from small (1 centimeter or less) to giant, cavernous hemangiomas (10 to 20 centimeters).
- Spontaneous rupture (bleeding) is rare.
Hepatic adenomas
- Benign solid neoplasms of the liver.
- Most commonly seen in young women.
- Typically solitary, although multiple adenomas also can occur.
- Prior or current use of oral contraceptives is a risk factor, although it can occur even without oral contraceptive use.
- Carry a significant risk of spontaneous rupture with intraperitoneal bleeding and risk of becoming cancerous (hepatocellular carcinoma).
Focal nodular hyperplasia (FNH)
- Another benign solid lesion of the liver.
- More common in women of childbearing age (similar to adenomas), although the link to oral contraceptive use is not as clear.
- Usually do not rupture spontaneously.
- Carry no significant risk of becoming cancerous.
Hepatic cysts
- Fluid-filled structures of the liver.
- Different types of hepatic cysts include:
- Simple liver cysts
- Biliary cysts
- Parasitic cysts
- Cystadenomas
How common are benign liver masses?
The most common form of benign liver mass is the hemangioma, which is found in about 3% to 20% of adults between the ages of 30 and 50. This makes the occurrence of these masses relatively common. Other types of benign liver masses are less common, like focal nodular hyperplasia, which can be found in as little as 0.3% to 3% of the general population.
What causes benign liver masses?
Doctors are not sure what causes benign liver masses, but the potential causes can be linked to any condition that can damage the liver, such as cirrhosis, hepatitis B or C, or smoking. There is also evidence that increased amounts of estrogen can lead to the creation of these masses.
Benign liver mass risk factors
Any form of benign liver mass can come with complications, as its presence in the liver alone can impede its proper function.
If you already have a condition that can damage the liver, such as cirrhosis, you will be at an increased risk of a benign liver mass. In cases of hepatic adenomas, there is a link between increased estrogen levels from birth control.
Complications of benign liver masses
Left undiagnosed, these masses could continue to grow and lead to pain in the area or problems with the liver’s ability to function. If the masses grow large enough, they can seriously impede the liver and create symptoms similar to liver failure.
What Are the Signs and Symptoms of Benign Liver Masses?
Some cases of benign liver masses can have no symptoms at all. But most commonly, the growths will create pressure or pain in the side of the body.
Here’s what symptoms look like for each type of liver mass:
- Focal nodular hyperplasia (FNH) — Causes abdominal pain.
- Hemangiomas — Pain often occurs in lesions greater than 5 to 6 centimeters in size.
- Hepatic adenomas — Many people experience no symptoms. They can be associated with birth control use.
- Hepatic cysts (large) — May feel like abdominal pain or fullness, or a palpable mass.
When should I see a doctor about my benign liver mass symptoms?
If you are experiencing persistent and unexplained pain in your side, schedule an appointment with your doctor to have it examined. Many people with benign liver masses do not know they have them until another medical exam requires imaging of the same area. So, if you are experiencing symptoms that may be linked to a liver mass, contact your doctor as soon as you can.
Although these growths are essentially not harmful, they can hamper the liver’s ability to function fully and properly.
How Do You Diagnose Benign Liver Masses?
There are various types of benign liver masses, and each has its preferred treatment method. Differentiating benign liver lesions from cancers can sometimes be done by radiologic imaging studies alone.
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 and whether it is drawing blood flow.
FNH lesions are usually well defined, with a typical “central scar” on CT scans.
Hepatic cysts can generally be differentiated from solid lesions by ultrasound or CT scans.
It's helpful to compare the size of a lesion from prior imaging studies (if they exist) to determine if the mass is growing. Follow-up imaging is vital 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 unclear, a liver biopsy is often performed to examine a sample of the liver mass under a microscope. This outpatient procedure allows the liver pathologist to 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.
How Do You Treat Benign Liver Tumors?
Treatment depends on the size and location of the mass. If the growth is too large to remove surgically, the aim of treatment will first be to shrink the mass until it is a more manageable size for surgical removal.
Surgery for benign liver tumors
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:
- Length of hospital stay.
- Pain.
- Recovery time.
- Scarring.
Therapies for benign liver masses
If your tumor is too large to be removed with surgery, UPMC 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 make surgery possible.
- Manage your liver disease and extend your life.
What happens during liver resection?
Liver resection surgeries are becoming increasingly common, and doctors now offer a minimally invasive option as well.
During the procedure, your doctor will:
- Make three to four small incisions or one large incision in a traditional resection.
- Remove the masses of the liver.
- Close wound with medial adhesive or stitches.
How effective is treatment?
Surgical procedures to remove liver masses are usually very effective, but cannot eliminate the possibility of new growths occurring. The primary goal of treatment is to completely remove the existing growths and restore the liver to its normal function. Removing what is already present cannot prevent the chance of new liver masses.
How long does it take to recover after resection for benign liver masses?
You may need to spend one or two days in the hospital for a resection surgery, as you will need to be prepped, examined, operated on, and monitored post-operatively. You might need to remain in the hospital should there be any complications with your surgery. Usually, you can be released within a few days of your resection surgery.
