Liver Tumor, Causes, Signs and Symptoms, Diagnosis and Treatment.

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07/13/23

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Chapters

0:00 Introduction
1:51 Causes of Liver tumor
2:41 Symptoms of Liver tumor
3:09 Diagnosis of Liver tumor
3:42 Treatment of Liver tumor

Liver tumors (also known as hepatic tumors) are abnormal growth of liver cells on or in the liver. Several distinct types of tumors can develop in the liver because the liver is made up of various cell types.[1] Liver tumors can be classified as benign (non-cancerous) or malignant (cancerous) growths. They may be discovered on medical imaging (even for a different reason than the cancer itself), and the diagnosis is often confirmed with liver biopsy.[2] Signs and symptoms of liver masses vary from being asymptomatic to patients presenting with an abdominal mass, hepatomegaly, abdominal pain, jaundice, or some other liver dysfunction. Treatment varies and is highly specific to the type of liver tumor.[3] Liver tumors can be broadly classified as benign or malignant:
Benign

There are several types of benign liver tumors. They are caused by either abnormal growth of neoplastic cells or in response to liver injury, known as regenerative nodules.[2] One way to categorize benign liver tumors is by their anatomic source, such as hepatocellular, biliary, or stromal.[2]: 693–704
Hemangiomas

Cavernous hemangiomas (also called hepatic hemangioma or liver hemangioma) are the most common type of benign liver tumor, found in 3%–10% of people.[2] They are made up of blood clusters that are surrounded by endothelial cells.[5] These hemangiomas get their blood supply from the hepatic artery and its branches.[5] These tumors are most common in women.[5] The cause of liver hemangiomas remains unknown; however, it may have congenital and genetic components.[5] They are not known to become malignant based on the available existing literature.[5]

Liver hemangiomas do not usually cause symptoms.[2][5] They are usually small, with sizes up to 10 centimeters.[5] Their size tends to remain stable overtime.[5] However, if the hemangioma is large it can cause abdominal pain, a sense of fullness in right upper abdominal area, heart problems, and coagulation dysfunction.[2][5] Cavernous hemangiomas are diagnosed with medical imaging (do not usually need biopsy to confirm diagnosis).[2]

Given their benign course and often asymptomatic nature, cavernous hemangiomas are typically diagnosed incidentally (e.g. when medical imaging is obtained for another reason).[5] In terms of management, they are usually monitored with periodic imaging as well as more closely if the person becomes pregnant.[5] If the cavernous hemangioma grows quickly or the patient is symptomatic, further medical intervention is warranted.[5] Therapies include open or laparoscopic surgical resection, arterial embolization, or radio-frequency ablation.[5] In terms of complications of hepatic hemangiomas, it is very rare for a hepatic hemangioma to rupture or bleed.[6]
Focal nodular hyperplasia

Focal nodular hyperplasia (FNH) is the second most common benign tumor of the liver.[2] FNH is found in 0.2%–0.3% of adults worldwide.[2] FNH is more common in females (10:1 female to male ratio) except in Japan and China, in which there is a more equal prevalence of cases between females and males.[2] FNH is associated with women of childbearing years and has been associated with women taking hormonal oral contraceptives.[2] This tumor is the result of a congenital arteriovenous malformation hepatocyte response. This process is one in which all normal constituents of the liver are present, but the pattern by which they are presented is abnormal.[citation needed]

These tumors usually do not have any symptoms. If large, they may present with abdominal pain.[2] It is common for patients to have multiple distinct liver lesions; however, they do not tend to grow over time and they do not typically convert to malignant tumors.[2] Diagnosis is made mainly with medical imaging, such as ultrasound or MRI with contrast.[2] The majority of FNH have a characteristic "central scar" on contrast-enhanced imaging, which helps to solidify the diagnosis.[2] However, if a central scar is not present on imaging, it is hard to tell the difference between FNH, hepatic adenoma, and hepatocellular carcinoma, in which cases biopsy is the next step to aid in the diagnosis process.[2]

Given the benign nature of FNH and the fact that they rarely progress in size or undergo malignant transformation, FNH tumors are usually managed with clinical monitoring.[2] Surgical indications or arterial embolization for FNH include if the FNH lesion is large, symptomatic, or there is uncertainty surrounding the correct diagnosis.[2]
Hepatic adenoma