Benign Liver Tumours

Question 1

What are the 3 typed of benign liver tumours?

Answer 1

Hepatic hemangioma (most common)
Foucal modular hyperplasia (FNH)
Hepatocellular adenopathies (rare)

Question 2

What is the peak age onset for all 3?

Answer 2

Hemangioma - 30-50 years
FNH - 30-40’s but later in men
Adenoma - 15-45 years

Question 3

What are the aetiologies for each of the cancers?

Answer 3

Hemangioma - hormonal component - oestrogen therapy associated with increased growth
FNH - mostly unknown
Adenoma - oral contraceptives and anabolic steroids

Question 4

What are the clinical features?

Answer 4

Usually asymptomatic
Large tumours may present with upper abdominal pain, fullness and nausea

Question 5

What is the best diagnostic test for the tumours? and what are the further imaging tests done?

Answer 5

Ultrasonography - best initial testy

Further imaging - contrast enhanced CT scan - to characterise the lesions
MRI

Biopsy - to confirm diagnosis if imaging is inconclusive - contraindicated in hepatic hemangioma as it may cause bleeding

Question 6

What is the treatment course for each of the tumours?

Answer 6

Conservative treatment is often sufficient for hepatic hemangioma and FNH
Surgical treatment if d symptomatic and or complications arise

For hepatocellular Adenoma - discontinue oral contraceptives
Women with symptoms or tumour >5cm are indicated for surgical resection
Men with hepatocellular Adenoma - indication for surgical resection irrespective of size of lesion due to increased risk of malignant transformation

Question 7

What will the diagnostic testing reversal for each of the tumours?

Answer 7

Look at amboss’ notes on benign liver tumors for the table