What is a benign liver lesion?

A liver lesion is a focal area of abnormality within the liver that looks different to the areas surrounding it. There are various possible types of liver lesion, many of them are benign and not of any significant health concern. Frequently, lesions in the liver are found by chance when a person has a scan of the abdomen, quite often for entirely unrelated reasons. There are, of course, some lesions that may indicate a more serious pathology, and liver lesions may occasionally turn out to be a tumour or cancerous. For this reason, all liver lesions need to be fully investigated and characterised when they are first detected.

Typically, lesions in the liver do not cause any symptoms. If they are very large or close to the surface of the liver, they may cause complaints such as pain/discomfort over the liver area (right upper part of the abdomen), a feeling of fullness or swelling, or difficulties with eating normal sized meals.

There are many different types of benign liver lesion. Common ones include a simple liver cyst and a haemangioma, which is an innocuous accumulation of tissue fluid and a collection of blood vessels, respectively. Other types of liver lesion include a hepatic adenoma and focal nodular hyperplasia (FNH), two types of benign growth.

What type of scan do I need?

The most common initial scan of the liver is an ultrasound (US) scan, and it may be that the liver lesion is first picked up on this test. An US scan is good for picking up the presence of lesions and determining their number and size, but may not always be able to determine with certainty the exact nature. This is best confirmed with an MRI scan, and often a contrast agent is injected into the vein during the test to provide more information.

Occasionally a CT scan with contrast is used instead or in addition. The scans are read by expert radiologists specialising in liver disease, and on occasions, scans may be reviewed in an MDT (a meeting of a group of specialists to review important clinical cases) to gain a consensus opinion. Rarely, a biopsy of the lesion is recommended to make a definitive diagnosis, but this is not normally necessary.

What do I need to do about my benign liver lesion?

The most important aspect of the management of a benign liver lesion is to confirm the diagnosis. Many types of benign liver lesions, such as simple liver cysts or haemangiomas, require no further intervention or monitoring unless they are causing symptoms, which is rare. Other types, such as a liver adenoma, may need monitoring with scans in the long-term to ensure they are not growing or changing. Rarely, the best course of action may be to remove the lesion, and this typically involves surgery.

Your liver specialist will be able to fully assess the nature of your condition and discuss with you the diagnosis and management options. He/she may also be able to provide a second opinion on scans performed elsewhere, if this is what is required.

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