RT Book, Section
A1 Zaydfudim, Victor M.
A1 Adams, Reid B.
A2 Morita, Shane Y.
A2 Balch, Charles M.
A2 Klimberg, V. Suzanne
A2 Pawlik, Timothy M.
A2 Posner, Mitchell C.
A2 Tanabe, Kenneth K.
SR Print(0)
ID 1145764563
T1 Benign Liver Tumors
T2 Textbook of Complex General Surgical Oncology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071793315
LK hemonc.mhmedical.com/content.aspx?aid=1145764563
RD 2024/04/19
AB In  practice,  patients  with  benign  liver  tumors  typically  present  in  three  broad  clinical  scenarios:  (1)  a  liver  tumor  incidentally  discovered  in  an  asymptomatic  patient,  (2)  a  liver  tumor  identified  during  surveillance  in  a  patient  with  a  history  of  malignancy  or  chronic  liver  disease,  and  (3)  a  liver  tumor  discovered  during  evaluation  of  upper  abdominal  symptoms.  Advances  in  cross-sectional  imaging  coupled  with  increased  utilization  have  led  to  an  increase  in  the  incidental  identification  and  diagnosis  of  benign  liver  tumors.  The  vast  majority  of  incidentally  discovered  liver  tumors  are  benign,  do  not  cause  symptoms,  and  do  not  require  resection.  When  symptoms  are  present,  typically  they  are  vague,  ill-defined  complaints  presumably  related  to  stretching  of  Glisson's  capsule  or  associated  with  a  mass  effect  from  compression  of  adjacent  structures.  Hence,  since  the  majority  of  these  benign  liver  masses  are  asymptomatic  and  some  patients  have  unrelated,  vague  upper  abdominal  symptoms,  the  onus  is  on  the  clinician  to  ascertain  causality  as  precisely  as  possible  to  determine  the  need  for  surveillance  or  a  treatment  strategy  and  to  avoid  unnecessary  treatment.  In  this  chapter,  the  clinical  features  and  treatment  options  for  the  three  most  common  benign  solid  liver  tumors  are  discussed:  hepatic  hemangioma,  focal  nodular  hyperplasia,  and  hepatocellular  adenoma  (HA).  Other  rare,  unusual  benign  liver  tumors  are  reviewed  in  brief.  Cystic  tumors  are  discussed  elsewhere.  Table  136-1  illustrates  the  broad  differential  diagnosis  of  benign  liver  tumors.  With  the  exception  of  HA,  the  majority  of  benign  liver  tumors  are  not  associated  with  malignancy  and  do  not  require  resection  if  the  diagnosis  can  be  established  without  an  operation.  Minimally  invasive  operative  techniques  should  not  expand  the  indication  for  resection  of  benign  liver  tumors.