Postgraduate Course at DDW: Complete Clinical Updates for Today's Practice

8_Singal - liver mass

Pdf Summary

The document outlines the diagnostic challenges and management of liver space-occupying lesions, particularly in chronic liver disease (CLD). Dr. Amit G. Singal, an expert in hepatology, discusses the differential diagnosis of liver lesions, which can be benign or malignant. Common benign lesions include hepatic cysts, hemangiomas, focal nodular hyperplasia (FNH), and adenomas. Malignant lesions include hepatocellular carcinoma (HCC), cholangiocarcinoma, fibrolamellar HCC, angiosarcoma, and metastatic disease.<br /><br />Hepatic cysts, usually asymptomatic, are diagnosed by imaging showing thin-walled cystic lesions. Hemangiomas are the most common benign solid liver lesions and can be identified by their nodular centripetal filling on imaging. FNH is the second most common benign tumor and is characterized by a central scar on imaging. Hepatic adenomas are associated with oral contraceptive use and have risks of rupture or malignant transformation, warranting management strategies such as stopping OCPs or surgical resection if symptomatic or large.<br /><br />The document also discusses the Liver Imaging Reporting and Data System (LI-RADS), which helps characterize liver lesions in individuals with CLD. Indeterminate nodules categorized as LR-3 or LR-4 have a risk of developing HCC. While empirical treatment for such lesions isn't always recommended, surveillance and potential biopsy are necessary to ensure accurate diagnosis and management.<br /><br />Ultimately, while benign lesions often need no treatment, certain adenomas may require intervention. LI-RADS assists in stratifying risk and guiding the management of suspicious liver masses, highlighting the importance of regular monitoring and biopsy in CLD patients who display signs of malignancy. Multi-disciplinary clinics can enhance imaging interpretation and offer patients comprehensive management options.

Keywords

liver lesions

chronic liver disease

hepatocellular carcinoma

benign lesions

malignant lesions

LI-RADS

hepatic adenomas

differential diagnosis

imaging

multi-disciplinary clinics