Liver mass natural history, complications and prognosis: Difference between revisions
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{{CMG}} ; {{AE}} {{ADG}} | {{CMG}} ; {{AE}} {{ADG}} | ||
==Overview== | ==Overview== | ||
In the majority of cases of liver mass, patients are asymptomatic. Benign liver lesions generally remain stable through out without undergoing any changes. However, without treatment, patient with malignant lesions will develop symptoms of [[jaundice]], [[ascites]], [[cachexia]], [[right upper quadrant]] abdominal pain, [[nausea]], and [[vomiting]], which will eventually lead to death. Common complications of liver mass include extrinsic compression of adjacent structures, hemorrhage, and liver failure. Due to the late presentation, the [[prognosis]] of malignant lesions is poor even with treatment. However,prognosis of benign liver mass is generally good with appropriate treatment. | |||
==Natural History== | ==Natural History== | ||
Benign liver lesions generally do not change over time in size. They do remain stable through out although occasionally they become smaller. However, in the setting of OCPs and during pregnancy enlargement of lesions have been reported. Malignant transformation of benign lesions is very rare except for hepatic adenoma which has 8-15% potential. | |||
==Complications== | ==Complications== | ||
Common complications of liver mass include: | Common complications of liver mass include: | ||
* | *Can transform into malignant lesion | ||
*Extrinsic compression of adjacent structures | *Extrinsic compression of adjacent structures | ||
* | **Compression of bile ducts and nearby arteries and veins | ||
**Gastric compression | |||
*Hemorrhage | |||
**Hemoperitoneum | |||
**Intratumoral bleeding | |||
* [[Liver failure]] | |||
==Prognosis== | ==Prognosis== | ||
=== Prognosis of malignant lesions === | |||
* Due to the late presentation, the [[prognosis]] of malignant lesions is poor even with treatment. | |||
* Without treatment, malignant lesions will result in early death. | |||
* The survival rate of malignant lesions is less than 50 percent. | |||
* The [[prognosis]] depends on the following: | |||
** Operable vs inoperable [[cancer]] | |||
** Cancer staging: Size and [[metastasis]] play a major role in [[prognosis]] | |||
** Patient’s general health | |||
** Time of [[cancer]] [[diagnosis]] | |||
=== '''Prognosis of benign lesions''' === | |||
===== '''Hepatic adenoma''' ===== | |||
* Prognosis is generally good with appropriate treatment. | |||
* Resolution of the lesion even with treatment is uncertain. | |||
* The risk of malignant transformation as high as 8-13%. | |||
===== FNH ===== | |||
* Prognosis of FNH is generally excellent as mostly lesions stay stable. | |||
* There is no evidence for malignant transformation of FNH. | |||
===== Hemangioma ===== | |||
* Prognosis of hemangioma is generally excellent. | |||
* There is no evidence for malignant transformation of associated with hemangioma. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 21:57, 6 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
In the majority of cases of liver mass, patients are asymptomatic. Benign liver lesions generally remain stable through out without undergoing any changes. However, without treatment, patient with malignant lesions will develop symptoms of jaundice, ascites, cachexia, right upper quadrant abdominal pain, nausea, and vomiting, which will eventually lead to death. Common complications of liver mass include extrinsic compression of adjacent structures, hemorrhage, and liver failure. Due to the late presentation, the prognosis of malignant lesions is poor even with treatment. However,prognosis of benign liver mass is generally good with appropriate treatment.
Natural History
Benign liver lesions generally do not change over time in size. They do remain stable through out although occasionally they become smaller. However, in the setting of OCPs and during pregnancy enlargement of lesions have been reported. Malignant transformation of benign lesions is very rare except for hepatic adenoma which has 8-15% potential.
Complications
Common complications of liver mass include:
- Can transform into malignant lesion
- Extrinsic compression of adjacent structures
- Compression of bile ducts and nearby arteries and veins
- Gastric compression
- Hemorrhage
- Hemoperitoneum
- Intratumoral bleeding
- Liver failure
Prognosis
Prognosis of malignant lesions
- Due to the late presentation, the prognosis of malignant lesions is poor even with treatment.
- Without treatment, malignant lesions will result in early death.
- The survival rate of malignant lesions is less than 50 percent.
- The prognosis depends on the following:
- Operable vs inoperable cancer
- Cancer staging: Size and metastasis play a major role in prognosis
- Patient’s general health
- Time of cancer diagnosis
Prognosis of benign lesions
Hepatic adenoma
- Prognosis is generally good with appropriate treatment.
- Resolution of the lesion even with treatment is uncertain.
- The risk of malignant transformation as high as 8-13%.
FNH
- Prognosis of FNH is generally excellent as mostly lesions stay stable.
- There is no evidence for malignant transformation of FNH.
Hemangioma
- Prognosis of hemangioma is generally excellent.
- There is no evidence for malignant transformation of associated with hemangioma.