13. Benign liver tumors (symptoms, diagnosis, treatment)

Question 1

Liver cystic lesions

Answer 1

Parasite or non-parasite

Question 2

Parasitic cyst

Answer 2

Ecchinococcus species

• Diagnosis: US, CT, MRI, ELISA, eosinophilia, anaphylaxis
• Therapy: Pericystectomy, ethanol/formaldehyde infusion and drainage

Question 3

Non-parasitic simple cyst treatment

Answer 3

surgery only if symptoms (laparoscopic cyst fenestration)

Question 4

Polycystic liver

Answer 4

Liver TX, US guided drainage (decompression -> less pain, better life, bridging)

Question 5

Non-cystic benign tumors

Answer 5

Focal Nodular Hyperplasia (FNH)

Liver hemangioma

Liver adenoma

Question 6

Focal Nodular Hyperplasia (FNH)

Answer 6

• Women, <1% malignant transformation, slow growth
• Diagnosis: central scar on CT, MRI, biopsy
• Treatment: laparoscopic resection if symptoms (>5cm) or uncertain diagnosis
• DD: hcc (may look similar on CT)

Question 7

Liver hemangioma

Answer 7

• Women, <5% rupture, grows slow (increased by pregnancy, contraceptives)
• Diagnosis: US, CT, MRI, blood pool scintigraphy
• NEVER biopsy!
• Operate if (laparoscopic): symptomatic, large, on liver surface, fast growth

Question 8

Liver adenoma

Answer 8

• Possible malignant transformation
• Fast growth
• Possible rupture and intrascapular bleeding
• Treatment: Liver resection