Liver lesions are areas of abnormal cell growth in the liver. In most cases, they are benign, do not cause symptoms, and are found incidentally during imaging tests done for other reasons.
The most common cause of liver lesions is a hepatic hemangioma, which is a blood vessel malformation present from birth. Other frequent causes include liver cysts and focal nodular hyperplasia.
Liver lesions should be evaluated by a hepatologist, who will review the person’s medical history and order imaging tests, such as a CT scan or MRI, to identify any abnormalities and determine the most appropriate treatment.
Symptoms of liver lesions
Liver lesions usually do not cause symptoms. However, when they become large, they may cause:
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Persistent pain or discomfort in the upper right side of the abdomen
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A feeling of pressure on nearby organs, such as the stomach or gallbladder
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Enlargement of the liver
In rare cases, a liver lesion may rupture, leading to severe pain.
How diagnosis is made
A liver lesion is usually diagnosed by a gastroenterologist or hepatologist through an evaluation of symptoms, medical history, and physical examination.
If a liver abnormality is suspected, the doctor may order imaging tests such as:
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Ultrasound
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Computed tomography (CT) scan
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Magnetic resonance imaging (MRI)
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Hepatic angiography
A liver biopsy may also be recommended, which involves removing a small tissue sample for analysis.
What liver lesions can be
The most common causes of liver lesions include:
1. Cysts and abscesses
Many liver lesions are actually cysts—fluid-filled sacs that are usually simple, benign, and asymptomatic. The exact cause is not known, but some cysts are congenital. In rare cases, they can be associated with conditions such as polycystic liver disease, parasitic infections, or cancer.
In some cases, the lesion may be a hepatic abscess, which is a collection of pus caused by an infection.
2. Focal nodular hyperplasia
Focal nodular hyperplasia is the second most common type of liver lesion, especially in women between 20 and 50 years old. It generally develops due to increased blood flow in the liver, causes no symptoms, and has a very low risk of becoming cancerous. Therefore, it typically only requires monitoring through imaging tests.
Although oral contraceptives do not cause this type of lesion, they may promote its growth. For this reason, women who use hormonal birth control are often monitored every 6 to 12 months.
3. Hepatic hemangioma
The most common type of liver lesion is a hepatic hemangioma, a benign malformation of blood vessels that is usually present from birth. In most cases, it does not cause symptoms and requires no treatment.
4. Hepatic adenoma
A hepatic adenoma is a rare, benign liver tumor that usually develops near the liver surface and often causes no symptoms. It is more common in women between 20 and 40 years old, mainly due to the use of oral contraceptives, which can increase the risk. Anabolic steroid use and pregnancy can also contribute to its development.
Are liver lesions dangerous?
Liver lesions can be benign or malignant. Most cases are benign, asymptomatic, and not dangerous to health.
However, malignant lesions are more serious, as they indicate cancer and may lead to complications. Therefore, it is important for a doctor to evaluate the type of lesion to determine the potential risk and appropriate treatment.
Are liver lesions a sign of cancer cancer?
When a person has no history of liver disease, most lesions are benign and not cancerous.
However, in people with liver conditions such as cirrhosis or hepatitis, there is a higher risk that a lesion may be cancerous, which is known as hepatocellular carcinoma.
Liver lesions can also result from cancer in another organ that spreads to the liver, known as liver metastasis.
Treatment options
In most cases, liver lesions do not cause symptoms and do not require treatment. Regular monitoring with a hepatologist and follow-up imaging tests are usually sufficient.
If a lesion grows larger, causes pain or discomfort by pressing on nearby organs, or shows signs of malignancy, surgical removal may be recommended.
In cases of cysts or abscesses, the doctor may drain the contents with a needle. If cysts are associated with genetic diseases that impair liver function, a liver transplant may be necessary.