Benign tumors of the liver: diagnosis and treatment management

Abstract

Introduction: Many benign liver lesions are an incidental finding in patients with no specific symptoms. However, in patients who are evaluated because of upper abdominal complaints, another difficulty is to make sure that the benign liver tumor and not the associated condition is indeed responsible for the symptoms. There is a bad correlation between a liver tumor and complaints and any benign tum or <5 cm is unlikely to be symptomatic. To perform a retrospective analysis of clinical material to develop optimal diagnostic and therapeutic tactics for patients with benign liver tumors and assessing postoperative outcomes. Materials and methods: The study was conducted on a group of 39 pacients with benign liver tumors who were hospitalized in Republican Clinical Hospital, Department of Hepato-biliarypancreatic Surgery. The patients have been examined for diagnosis and surgical treatment. Results: Benign liver tumors most commonly affect women to men (ratio of 3:1), which is possible due to the use of oral contraceptives, most lesions being detected between 41-50 and 61-70 years old. In the series of 39 patients, 30 were hemangiomas, 6 adenomas and 3 focal nodular hyperplasia. The complaints were grouped in 3 syndromes: the dolor syndrome (61%), dyspeptic syndrome (26%) and asthenia (13%). This feature reflects benign liver tumors to appear asymptomatic. All patients were investigated at US, CT or MRI, CT being the most specific method. The most common location is in VVII segments, corresponding to the right hepatic lobe. Predominate large tumors (> 10 cm). Changes in peripheral blood like anemia, thrombocytopenia, accelerated ESR are minimal. Tumor markers (CA 19-9, CEA, AFP) were elevated in only 5(13%) of 39 patients. Surgical treatment: 28 enucleations, 8 atypical resections, 3 anatomical resections. Prevalence of enucleation directly reflects predominance of hemangiomas. Postoperative complications were minimal with zero mortality. Conclusion: Benign tumors usually are asymptomatic, symptoms are more likely with large lesions, but a well-established diagnosis tactic includes US, CT and MRI. The treatment management is individual and depends on location, size of tumors and patients complaints. When surgery is not indicated, patients should be periodically evaluated by US and CT.