Liver mass history and symptoms

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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

The hallmark symptoms of liver mass, include right upper quadrant abdominal pain, pruritus, and unintentional weight loss. However, in some cases, liver masses may be asymptomatic. A positive history of chronic hepatitis, cirrhosis, nonalcoholic fatty liver disease, prolonged contraceptive use, and alcohol abuse may be suggestive of a liver mass. Symptoms related with liver mass will vary depending on the size and location of the tumor. Other symptoms of liver mass may also include loss of appetite, fatigue, nausea, and vomiting.

History

Obtaining the history is an important aspect of making a diagnosis of liver mass. Complete history will help determine the likelihood of malignancy, and the association with other conditions. Specific symptoms description such as duration, onset, and progression are important for making the diagnosis. Specific areas of focus when obtaining the history, are outlined below:

History
Personal history	Age Gender Recent travel history
Family history	Positive family history of liver diseases, such as: Crigler–Najjar syndrome Gilbert syndrome Dubin–Johnson syndrome Rotor's syndrome
Past Medical History	Previous hepatitis infection, such as: Hepatitis C infection Hepatitis B infection History of chronic liver disease Use of contraceptives
Social history	Positive history of smoking/alcohol abuse: Number of alcoholic beverages per week Number of years/months of active alcohol abuse Number of years/months of alcohol cessation

Symptoms

• In most cases, liver masses are asymptomatic and are usually found incidentally.
• The hallmark symptoms of liver mass may include right upper quadrant abdominal pain, pruritus, and unintentional weight loss.
• Other symptoms that suggest liver mass, include:
  • Abdominal pain
    • Dull pain
    • Pain radiating to the right scapular area or right shoulder
  • Cachexia
  • Fatigue
  • Loss of appetite or anorexia
  • Chest pain
  • Generalized pruritus
  • Nausea and vomiting