Liver mass evaluation

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

A hallmark feature in the evaluation of liver mass is the malignancy assessment. The evaluation approach of liver mass will mainly depend in the initial morphological evaluation of the mass (size, margins, contours, imaging pattern, and growth). Other characteristics, such as: location, clinical features, and distribution may be helpful for the therapeutical management, surveillance, and follow-up of liver mass. Lung mass can be divided into 2 categories: benign liver mass and malignant liver mass. Based upon these categories, complementary diagnostic studies and management, include: PET/CT scan, CT scan, non-surgical biopsy, and surgical resection.

Liver Mass Evaluation

• The algorithm below summarizes the initial liver mass evaluation

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Liver mass detected Adapted from Bonder et al.

Relevant medical history to obtain:

❑ Age and gender ❑ Symptoms: jaundice, pain, nausea ❑ Recent travel ❑ Hepatitis serology ❑ Iron studies ❑ Use of oral contraceptives ❑ AFP levels ❑ From endemic area of hepatitis ❑ History of chronic liver disease ❑ Physical findings

Chronic liver disease Hepatitis B or C

No history of chronic liver disease

Check AFP, triphasic CT or MRI Follow-up screening guidelines as cirrhotic patient

Benign characteristics of a liver mass Follow-up accordingly