Management of Benign Hepatic Tumors
Summary
Benign hepatic tumours encompass a spectrum of non-malignant lesions, including haemangiomas, focal nodular hyperplasia (FNH) and hepatic adenomas. Most lesions are discovered incidentally during imaging and, in the absence of symptoms, are managed conservatively with regular ultrasound or magnetic resonance surveillance. Intervention is reserved for symptomatic cases, rapid growth, diagnostic uncertainty or risk of complications such as haemorrhage or malignant transformation. Surgical enucleation or partial hepatectomy remains the gold standard for large or symptomatic haemangiomas and adenomas, while FNH is seldom resected except in rare circumstances. Minimally invasive techniques have gained prominence: laparoscopic and robotic hepatectomy offer reduced blood loss and shorter hospital stay compared with open approaches; radiofrequency ablation affords a percutaneous option for selected subcapsular lesions; and transcatheter arterial embolisation (TAE) or chemoembolisation (TACE) provides a viable alternative when surgery is contraindicated. Management decisions are guided by lesion size, location, patient comorbidity and histological subtype, ideally within a multidisciplinary liver clinic.
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Management of Benign Hepatic Tumors publication trend
The graph below shows the total number of articles in management of benign hepatic tumors across all publications each year (not limited to Nature Index journals).
Technical terms
Hepatic haemangioma: A benign vascular liver lesion lined by endothelial cells and filled with blood, often asymptomatic.
Focal nodular hyperplasia (FNH): A hyperplastic response of hepatocytes to vascular malformation, typically non-neoplastic and stable.
Hepatic adenoma: A benign epithelial tumour of hepatocytes, associated with hormonal factors and potential malignant transformation.
Transcatheter arterial embolisation (TAE/TACE): A minimally invasive technique that occludes arterial blood supply to a lesion, with or without chemotherapeutic agents.
Drug-eluting beads (DEB): Microspheres that release cytotoxic drugs locally within the embolised tumour vasculature.
Radiofrequency ablation (RFA): A percutaneous or laparoscopic procedure using thermal energy to induce coagulative necrosis of targeted tissue.
References
- I thought it was a hemangioma! A pictorial essay about common and uncommon liver hemangiomas’ mimickers. Insights into Imaging (2024).
- Transarterial Bleomycin–Lipiodol Chemoembolization for the Treatment of Giant Hepatic Hemangiomas: An Assessment of Effectiveness. Cancers (2024).
- Pingyangmycin-loaded drug-eluting beads transarterial embolisation for giant cavernous haemangioma of the liver: A case report. Heliyon (2024).
- Robotic, laparoscopic or open hemihepatectomy for giant liver haemangiomas over 10 cm in diameter. BMC Surgery (2020).
- Laparoscopic Radiofrequency Ablation for Large Subcapsular Hepatic Hemangiomas: Technical and Clinical Outcomes. PLOS ONE (2016).
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