Liver lesions are cell abnormalities within the liver. They are most often benign, but some can be cancerous. Liver lesions can be caused due to a variety of reasons. However, most of the lesions don't cause any symptoms until they develop into larger masses. Symptoms include abdominal pain or swelling, nausea, vomiting, and changes in the color of urine or stool. The most common form of benign liver lesions are hemangiomas. These are abnormal formations of blood vessels. Commonly, these lesions don't need to be treated. Hepatocellular carcinoma is the most common type of malignant liver lesions. Hepatologists evaluate patients with liver lesions and help determine what kind of further evaluation and follow up is needed.
Key facts
- Haemangioma and focal nodular hyperplasia are the two most frequent benign liver lesions and only exceptionally require treatment, specific advice or follow-up
- Hepatocellular adenoma, which occurs in obese females, is a heterogeneous liver lesion at risk of bleeding and malignant transformation according to the patients' gender and the pathological subtype and size of the tumor
- In women, the low risk of complications associated with hepatocellular adenomas of <5 cm allows conservative management with regular follow-up
- The accuracy of MRI limits the use of biopsy for the diagnosis of hepatocellular adenoma, focal nodular hyperplasia or haemangioma
Symptoms
Benign liver lesions most commonly don’t cause any symptoms. Many people find out they have one when they go for an imaging test, like an ultrasound, for a completely different health issue. If it does cause problems, your symptoms will depend on the type you have. They might include:
- Bloating, swelling, or pain in your belly
- A feeling of fullness
- Nausea and vomiting
- Feeling weak or tired
- Fever
Causes
It's not clear what causes a liver hemangioma to form. Doctors believe liver hemangiomas are congenital. This means that you're born with them. Also, a liver hemangioma usually occurs as a single abnormal collection of blood vessels that is less than about 1.5 inches wide. Occasionally liver hemangiomas can be larger or occur in multiples. Large hemangiomas can also occur in young children but this is extremely rare. In most people, a liver hemangioma will never grow and never cause any signs and symptoms. But in a small number of people, a liver hemangioma will grow to cause complications and require treatment. It's not exactly clear why this happens.
Treatment
If you don’t have any symptoms, you may not need to do anything about the liver lesion. If it’s causing issues for you but it is not cancerous, your doctor may recommend surgery to take it out.
If the liver lesion is cancerous, you might need one or more of these:
- Chemotherapy: This is a combination of powerful drugs that are designed to kill cancer cells. It’s the most common treatment for liver lesions that are spreading to other parts of your body.
- Transarterial chemoembolization (TACE): This is a targeted type of chemotherapy that takes anti-cancer drugs directly to the liver lesion. They flow through a tiny tube that is called a catheter into the artery that brings blood to your liver. This also blocks some of the blood flow to your liver. Ultimately, this keeps the cancer cells from getting the oxygen they need to grow. TACE causes fewer side effects than regular chemotherapy.
- Radiofrequency ablation (RFA): If your liver lesion is small, your doctor may recommend this procedure. He’ll guide a small probe into the tumor in your liver, usually through tiny cuts in your belly. The probe will give off a certain kind of energy that heats up and kills cancerous cells.
You can lower your chances of getting cancerous liver lesions if you exercise, stay at a healthy and balanced weight, and drink only in moderation. And you can do a few things to keep from getting hepatitis B or C, which cause 80% of liver cancer cases. You can get vaccinated against hepatitis B, wear condoms when you practice sex, and avoid sharing needles if you use them to do recreational drugs.
