Liver mass overview
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American Roentgen Ray Society Images of Liver mass overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Liver mass (also known as "hepatic mass") is generally defined as the neoplastic growth of tissue in the liver. Abnormal growths found in the liver can be benign or malignant. Liver mass may be classified according to imaging features (hyperechoic vs. hypoechoic), histopathological origin (benign vs. malignant), and distribution (single/focal/solitary vs. multiple).[1] The most common cause of a liver mass is liver cancer. Common causes of benign liver mass, include: hepatic hemangioma, focal nodular hyperplasia, hepatic adenoma, idiopathic noncirrhotic portal hypertension (including nodular regenerative hyperplasia, regenerative nodules. Conversely, common causes malignant liver masses, include: hepatocellular carcinoma, cholangiocarcinoma, metastatic disease. "Primary liver tumors", which originate in the liver or from hepatic-derived cells and tissues, and "secondary tumors" which originate in other sites and metastasize to the liver.
Classification
Liver mass may be classified according to imaging features (hyperechoic vs. hypoechoic), histopathological origin (benign vs. malignant), and distribution (single/focal/solitary vs. multiple).[1]
Causes
The most common cause of a liver mass is hepatocellular carcinoma. Common causes of benign liver mass, include: hepatic hemangioma, focal nodular hyperplasia, hepatic adenoma, idiopathic non-cirrhotic portal hypertension, nodular regenerative hyperplasia, regenerative nodules. Common causes malignant liver masses, include: hepatocellular carcinoma, cholangiocarcinoma, metastatic disease
Differentiating Liver Mass from Other Diseases
Liver mass may be differentiated according to clinical features, laboratory findings, imaging features, histological features, and genetic studies, from other diseases that cause abdominal pain, pruritus, low-grade fever, and ascities. Common differential diagnosis includes: liver abscess, simple liver cyst, and fungal infections.
Epidemiology and Demographics
Liver masses are common. The annual incidence rate of malignant liver mass is approximately 6 per 100,000 individuals in the United States. The incidence rate of liver mass increases with age; The median age at diagnosis varies widely between 5 to 60 years. Females are more commonly affected with benign liver masses than males. The female to male ratio is approximately 2.3 to 1. However, males are more commonly affected with malignant liver masses than females. The male to female ratio is approximately 3 to 1. The incidence of malignant liver mass varies widely according to the ethnicity and geographic location.
Screening
According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for liver mass.[2]
Diagnosis
Evaluation of Liver Mass
History and Symptoms
Physical Examination
Laboratory Findings
Imaging
Chest X Ray
CT
MRI
Other Imaging Studies
Other Diagnostic Studies
Treatment
Therapeutic Management
Surgery
Prevention
References
- ↑ 1.0 1.1 Mergo PJ, Ros PR. Benign Lesions of the Liver. In: The Radiologic Clinics of North America, 2, W.B. Saunders, Philadelphia 1998. Vol 36, p.319.
- ↑ Recommendations. US preventive services task force(2015) http://www.uspreventiveservicestaskforce.org/BrowseRec/Search?s=liver+mass Accessed on March, 24th 2016