What are benign liver masses?
Benign liver masses are non-cancerous tumors or lesions in the liver. They are relatively common and may be detected on imaging studies incidentally or as part of an investigation into abnormal liver function or abdominal pain. Sometimes radiologic imaging studies alone can distinguish benign liver lesions from cancers. However, if the diagnosis remains unclear, Jefferson’s specialists will order a liver biopsy to examine and diagnose a piece of the mass tissue under the microscope. Whenever possible, it helps to compare the size of the lesion to prior imaging studies, which can help determine whether or not the mass is growing. If the patient is experiencing abdominal pain or if the diagnosis is still in question after the evaluation, resection of the benign liver masses may be warranted. Follow-up imaging is critical to ensuring that the lesion is not growing.

What are the different types of benign liver masses?
There are several types of benign liver masses, including:

• Hemangioma. Hemangiomas (also referred to as hemangiomata) are the most common benign masses that occur in the liver. They are vascular lesions containing fibrous tissue and small blood vessels that are present at birth but eventually grow. In terms of size, they can range from small (1 cm or less) to giant cavernous hemangiomas (10-20 cm). Pain is the most common symptom, particularly in lesions greater than 5-6 cm in size. Spontaneous bleeding is rare, and the main indication for resection is pain. If the suspected diagnosis is hemangioma, the physician may or may not order a liver biopsy; there is a risk of bleeding from the biopsy site, especially when the lesion is at the edge of the liver.
• Adenoma. Hepatic adenomas are benign solid neoplasms of the liver most commonly seen in young women. Although these masses are typically solitary, multiple adenomas can occur. Prior or current use of oral contraceptives is a clear risk factor for development of a liver adenoma; however, they can arise even when there’s been no use of birth-control pills. Hepatic adenomas carry a significant risk of spontaneous rupture with intraperitoneal bleeding. There is also a risk of malignant transformation to a well-differentiated HCC. As a result, surgical resection is often the optimal treatment for hepatic adenoma.
• Focal nodular hyperplasia (FNH). Focal nodular hyperplasia (FNH) is another solid, benign lesion of the liver. These masses are usually well-circumscribed and show a typical “central scar” on CT imaging. Like adenomas, they’re more common in women of childbearing age. Unlike adenomas, the link to oral contraceptive use is not as clear. Also unlike adenomas, FNH lesions usually do not rupture spontaneously and have no significant risk of malignant transformation. Abdominal pain is the main indication for surgical resection.
• Hepatic cyst. Liver cysts are fluid-filled structures that can be usually distinguished from solid lesions by ultrasound or CT scan imaging. There are several different kinds of liver cysts: simple liver cysts, biliary cysts, parasitic cysts and cystadenomas. Treatment varies based on the cause of the cysts. Large cysts often present with abdominal pain or fullness, as well as a palpable mass. Surgical resection is the definitive treatment; however, simple cysts can sometimes be managed by aspiration with or without sclerotherapy.

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To schedule an appointment with a Jefferson physician call 1-800-JEFF-NOW or click here.

To contact the Liver Tumor Program team at the Kimmel Cancer Center at Jefferson, please call 215-503-8752 and/or fax your records to 215-503-8755. We aim to schedule your first clinic visit within two weeks of your diagnosis being made and records being received.