Benign neoplasms of the liver

Abstract

Tumors of the liver often are discovered incidentally in asymptomatic individuals during diagnostic imaging or exploratory laparotomy performed for alternative reasons. Hemangiomas are the most common benign liver tumors, followed in prevalence by focal nodular hyperplasia (FNH); other benign tumors are rare. The growth and development of hemangiomas, FNH, and hepatic adenomas especially, have been linked to hormonal (eg, estrogen) stimulation. Differentiating between benign and malignant neoplasms of the liver can be challenging. Radiologic imaging is essential for preliminary identification and classification of hepatic tumors, but tissue biopsy or surgical excision sometimes is required for a definitive diagnosis. Individuals with hemangioma or FNH usually are asymptomatic, have a benign course, and can be managed conservatively. In contrast, hepatic adenomas need to be followed more carefully and often are excised to provide symptomatic relief, remove the risk of rupture, and avoid potential malignant transformation. Liver transplantation in patients with benign hepatic neoplasms is exceedingly uncommon, and is recommended only when alternative methods of treatment are not feasible or have failed to control significant symptoms.

Enhanced Growth of Hepatic Hemangiomatosis in Two Adults after Postmenopausal Estrogen Replacement Therapy

“…Etiology of hemangiomas is not well defined, but the affects of female sex hormones are debated. Hepatic hemangioma is seen 5-6 times more frequently in women than men in adults (Ochsner and Halpert 1958;Porayko and Choudhray 2001;Reddy et al 2001). In addition, female patients often develop larger and multiple tumors than men (Reddy et al 2001), and rapid enlargement of hemangioma during pregnancy are also reported (Saegusa et al 1995).…”

“…Incidence of the liver hemangioma is approximately 2% in population with the predilection of female sex (Ochsner and Halpert 1958;Porayko and Choudhray 2001;Reddy et al 2001). It is usually solitary but can be multiple in some cases.…”

Hepatic haemangiomas: possible association with female sex hormones

“…Lesions smaller than 6 cm in diameter characteristically demonstrate a well demarcated, homogeneous, hyperechoic ultrasonographic pattern that may establish the diagnosis in 80% of patients. 4 Larger haemangiomas are more heterogenous, often complicated by thrombosis, calcification, or haemorrhage, and require further imaging by computed tomography (CT) scan or magnetic resonance imaging (MRI).…”

Cavernous hemangioma of the liver

“…[1-2] Many patients are asymptomatic, but in others, symptoms may vary from abdominal discomfort to life-threatening complications. [1] Women are more often affected by hepatic hemangioma,[3] and some studies have found that women exposed to exogenous estrogens, progesterone, contraceptives or hormone replacement therapy show a significant increase in the size of their tumors.…”