Benign Liver Tumors
Hepatocellular adenoma is the most important benign tumor t. It occurs primarily in women of childbearing age, particularly those taking oral contraceptives, possibly via estrogen’s effects. Most adenomas are asymptomatic, but large ones may cause right upper quadrant discomfort. Rarely, adenomas manifest as peritonitis and shock due to rupture and intraperitoneal hemorrhage.
Rarely, they become malignant. Diagnosis is often suspected based on ultrasound or CT results, but biopsy is sometimes needed for confirmation. Adenomas due to contraceptive use may regress if the contraceptive is stopped. If the adenoma does not regress or if it is subcapsular or cm, surgical resection is often recommended.
Focal nodular hyperplasia
This localized hamartoma may resemble cirrhosis histologically.
Diagnosis is usually based on MRI or CT with contrast, but biopsy may be necessary for confirmation.
Treatment is rarely needed.
Hemangiomas are usually small and asymptomatic; they occur in 1 to 5% of adults.
Symptoms are more likely if they are > 4 cm; symptoms include discomfort, fullness, and, less often, anorexia, nausea, early satiety, and pain secondary to bleeding or thrombosis. These tumors often have a characteristic highly vascular appearance.
Hemangiomas are found incidentally during ultrasonography, CT, or MRI.
Treatment is usually not indicated.
Resection can be considered if symptoms are troublesome or if a hemangioma is rapidly enlarging.
Benign bile duct adenoma
Benign bile duct adenomas are rare, inconsequential, and usually detected incidentally. They are sometimes mistaken for metastatic cancer.
Lipomas and Fibromas
Lipomas (usually asymptomatic) and localized fibrous tumors (eg, fibromas) rarely occur in the liver