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Benign liver tumors

  • While being tested for liver cancer or another type of cancer, you may learn you have benign liver tumors.

    "Benign" means the tumor does not have cancer.

    Benign liver tumors are relatively common. They rarely cause symptoms and are usually found if you're having an ultrasound, CT scan or other imaging test for another condition.

    Liver cysts: What are they and how are they treated?

    Cysts in the liver are benign tumors that are filled with fluid.

    Liver cysts: What are they and how are they treated?
    Type Symptoms >Recommended treatment
    Simple (congenital) cysts are the most common benign liver tumors. This type of cyst is lined with bile duct cells that are not connected with the bile duct system. Simple liver cysts rarely cause symptoms, unless they are large. With a large cyst, you may feel stomach pain, or have a feeling of fullness or heaviness in the upper abdomen.

    The cyst is aspirated (emptied through a needle placed by a radiologist), injected with 100 percent alcohol, and then drained again. This method is called PAIRS – puncture, aspiration, injection and reaspiration.

    If PAIRS fails or is not possible, then laparoscopic unroofing is usually the next step. This outpatient surgery is successful more than 95 percent of the time.

    Polycystic liver disease is a genetic disorder that causes many cysts to form in the liver. They may range from a few small cysts to many large cysts. Large cysts may cause fullness, trouble eating, and pain which is chronic and unrelenting.

    As with simple cysts, PAIRS or laparoscopic unroofing are the treatment options if a few large cysts are causing problems.

    If many cysts are causing the liver to enlarge, removing part of the liver (resection) may be recommended. Liver transplant is reserved when the other treatments are not possible and when there is liver failure.

    Biliary cystadenomas result from abnormal growth of biliary tract cells in the liver. They are not very common and can be found with a CT scan or MRI scan. The symptoms are the same as with other liver cysts and are often seen in women older than 40 years of age. Biliary cystadenomas have a small risk of turning into cancer, so complete removal is recommended. This usually can be done byenucleation, a surgery that removes the cyst without breaking it like one would shell a nut.
    Liver abscesses are collections of pus and bacteria in the liver. They come from other infections like colon inflammation or heart valve infections. Liver abscesses may also occur after endoscopic bile duct studies (ERCP). Symptoms can include pain in the right side of the upper abdomen (belly), fever, sweats and chills.

    Ultrasound, CT and MRI scans can find the abscess and be used to help drain it.

    Intravenous antibiotics are usually effective when combined with drainage.

    Surgery is rarely necessary.

    Benign solid liver tumors: What are they and how are they treated?

    Benign, solid liver tumors are often spotted during ultrasound, CT and MRI.

    Benign solid liver tumors: What are they and how are they treated?
    Type Symptoms Recommended treatment
    Hepatic adenomas (liver cell adenoma, hepatocellular adenoma) are most common in women who have taken birth control pills (oral contraceptives) for a long time. They are made of liver cells (hepatocytes). Pain is the most common symptom but is not always present. However, as many as 25 percent of these lesions are found due to heavy bleeding after they rupture.

    Since many patients with adenomas are taking birth control pills, stopping these drugs is the first line of therapy. Tumors in some patients will shrink after withdrawal of birth control pills.

    Adenomas larger than 4 centimeters should be surgically removed as there is a risk of rupture and a small risk of cancer.

    Clotting the blood supply with embolization is a first line therapy for a bleeding adenoma.

    Radio frequency ablation may help patients with many adenomas.

    Focal nodular hyperplasia is an overgrowth of normal liver cells.

    Focal nodular hyperplasia typically does not have symptoms. In rare cases, it may cause pain.

    In contrast to hepatic adenomas, it does not cause bleeding or have a risk of cancer.

    Usually, no treatment is needed.

    If you have pain or other symptoms, you may have surgery to remove the tumor.

    Hepatic hemangiomas are disorganized collections of small blood vessels in the liver. Usually, they show up incidentally on an x-ray.

    Symptoms are uncommon but may include chronic abdominal pain and problems with eating, especially when the lesions are large.

    They rarely cause blood disorders (including platelet problems).

    As with any benign liver tumor, other causes of abdominal pain should be sought before considering surgery. Hemangiomas can be removed by laparoscopic or open surgery.
  • Source: Virginia Piper Cancer Institute; Stedman's Medical Dictionary, 28th edition
    Reviewed by: Timothy Sielaff, MD, PhD, FACS, medical director, Virginia Piper Cancer Institute
    First published: 08/26/2009
    Last reviewed: 08/26/2009