Mass on liver is increasingly being detected unintentionally when patients are evaluated to unrelated reasons. Mass on liver is relatively common in liver. Mass on liver are usually non cancerous in patient without showing liver disease and usually needed no specific treatment.
Solid mass on liver
The most common solid masses including:
- Focal nodular hyperplasia.
- Focal fatty change.
- Nodular regenerative hyperplasia.
Hemangiomas is the most common of all benign liver mass. They are most common in women and that may be affected due to hormonal change. Most common symptoms are pain mostly noted the mass on liver less than 6cm and that are related construct to adjacent structure. Mass on live bleeding is rare. No specific treatment is needed for asymptomatic mass on liver. Sometime surgical resection is the treatment for the mass on liver.
- The most common benign solid mass on liver.
- Represent congenital vascular liver mass that contain fibrous tissue and also small blood vessels that eventually grow.
- Range in size normally from small (1 centimeter or less) to giant, cavernous hemangiomas is (10 to 20 centimeters).
- Spontaneous bleeding is rare.
- Diagnosis of mass on liver is usually with magnetic resonance imaging (MRI).
- Most hemangiomas are detected with ultrasound.
- Increased sound transmission is another important feature of hemangiomas.
- In 60% of cases more than one hemangioma is present.
- The size is varies from a few millimeters to more than 10 cm.
- CT scan will show hemangiomas as sharply defined masses on liver.
Adenoma is strongly associated with oral contraceptive pill use. Normally larger adenomas that are less than five centimeter may present with abdominal pain or a feeling of fullness. Fevers, vomiting, and nausea are also major symptoms of hepatic adenoma. Larger mass on liver have a great tendency to bleeding also have a chance to become cancerous. Mass on liver is sometime diagnosis by sometime by biopsy and combination of radiographic examinations. Oral contraception must me avoid and it is the first line treatment.
- Benign solid neoplasms of the liver.
- Most commonly seen in young women.
- Typically solitary, although multiple adenomas also can occur.
- Use of oral contraceptives is major risk factor, but also can occur without oral contraceptives.
- Carry significant risk of spontaneous rupture and with intraperitoneal bleeding and risk of becoming cancerous.
- Hepatocellular adenoma is large, well circumscribed encapsulated tumors.
- More than 80% of adenomas are solitary and 20% are multiple.
- Adenomas normally measure 8-15 cm and consist of sheets of well-differentiated hepatocytes.
- MRI technique usually is more sensitive to detecting fat and hemorrhage.
- CT scan will show most adenomas mass on liver with homogeneous enhancement into the late arterial phase.
- Hepatic Adenomas may rupture and bleed that causing right upper quadrant pain.
- The two most common liver mass causing hepatic hemorrhage are HCC and HA.
- Patients who have glycogen storage disease, acromegaly , hemochromatosis, or males on anabolic steroids also are risk to developing hepatic adenomas.
Focal nodule hyperplasia
Focal nodule hyperplasia is the second most common mass on liver. Focal nodule hyperplasia is not true neoplasm. It is believed to represent a hyperplasic response that increase blood flow into intrahepatic arteriovenous. Focal nodule hyperplasia is non specific ill-defined mass on liver. CT scan will show Focal nodule hyperplasia as a vascular tumor which will be hyper dens in the arterial phase. MRI will show a hypo intense central scar on T1-weighted images.
- Another benign solid lesion of the liver.
- More common in women of childbearing age those are similar to adenomas, although the link to oral contraceptive pill use is not as clear.
- Usually do not rupture spontaneously.
- Carry no significant risk of becoming cancerous.
- The diagnosis of focal nodule hyperplasia is based on the demonstration of a central scar and also a homogeneous enhancement.
- However, a typical central scar usually not is visible in as many as 20% of patients.
- The most common cause of mass on liver would be central necrosis in a tumor.
- This could also be an adenoma, but HCC that would be unlikely because they show a fast wash out.
Cystic mass on liver
Two major types of cystic mass on liver are exist and they can be either infectious or a non-infectious cause.
No infectious cystic mass on liver
Bile duct cysts
Bile duct cysts that may be present from birth or may be arise later in life. It may be higher possibilities to occur in women. If symptomatic the patient may present nausea, fever or jaundice, vomiting, present with pain under the right rib cage. The patient may present back pain in extreme cases. Patient may rarely present inflammation on liver or cirrhosis on live because of chronic obstruction of bile duct. Biopsy of bile duct is needed to indicate bile duct cancer.
Simple liver cysts
Simple liver cysts are a single cyst that located within the liver. Simple liver cysts are present from birth. Most of the cysts are asymptomatic and those are uncommonly diagnosed before the age 40. If symptomatic, the patients complain of abdominal pain and fullness. Diagnosis is made radio graphically. No specific treatment is needed. Infectious or cancerous causes as well as possible interaction with the bile duct system must be lined out prior to performing an operation.
Infectious cystic mass on liver
Amebic liver abscess
Amebic infection is most common infection in the tropics. In the United States persons at risk for amebic infection are those who have traveled to endemic areas. The organisms those are responsible for the disease process is Entamoeba Histolytica. Transmission is normally occurs via ingestion of infected water. Amebic Liver abscess formation occurs when the ameba is penetrates through the intestines and in the local veins that drain into the liver. Less than one-third of the abscess patients have intestinal symptoms prior during the diagnosis of liver abscess. Patients normally present with acute abdominal pain and fevers. Up to eight percent of patients present with mild jaundice and fever. Tests to detect antibodies in the blood are available and should be performed.
These hydatid liver cysts are caused by a parasitic organism and found in dogs. Echinococcus multilocularis are major parasite that infected dog. Tapeworm embryos are normally present in the feces of dogs. After unintentional ingestion, the tapeworm embryo will usually penetrate the intestine and normally find its way to the liver.