Benign Neoplasms of the Liver (Lecture 5a)

What is the m/c benign tumour of liver?

Cavernous hemangioma

What is a cavernous hemangioma? What is the m/c pt population?

- Hormone dependent benign tumour that consists of multiple vascular channels intertined w/ fibrous septae

- Pt population: young females (higher risk if use oral contraceptives)

TRUE or FALSE: Hemangiomas have potential for malignancy

FALSE

What other tests can be done to assess for a hemangioma?

Other tests: RBC scintigraphy, US microbubbles, contrast enhanced U/S, y, CT, MRI

What is the clinical presentation for hemangiomas?

Symptoms: Asymptomatic (m/c), pain (hemorrhage/thrombosis w/i large lesion).

What are SF for hemangiomas?

- Small (focal, well-defined, homogenous)

- Hyperechoic

- Posterior enhancement

- Doppler: no flow

What is the treatment for hemangioma?

Treatment: no treatment; if small, stop oral contraceptives.

What is focal nodular hyperplasia?

Benign liver tumour - developmental hyperplastic lesion (contains all cell elements of normal liver tissue but lacks normal arrangement)

TRUE or FALSE: Focal nodular hyperplasia has no risk of malignancy.

TRUE: No risk of rupture/malignancy.

TRUE or FALSE: Focal nodular hyperplasia is linked to oral contraceptive use.

FALSE: Hormone dependent - NOT linked to oral contraceptives.

What other tests are done to assess for focal nodular hyperplasia?

Other tests:

- Doppler - stellate vessels (rich vasculature in centre of mass)

- CEUS, biopsy

What is the clinical presentation and patient population for focal nodular hyperplasia?

CP: Women in childbearing yrs, asymptomatic

What are the SF for focal nodular hyperplasia?

SF:

- isoechoic

- small (less than 5cm)

- Central fibrous scar

TRUE or FALSE: Adenomas are linked with oral contraceptive use.

TRUE

TRUE or FALSE: Adenomas have a risk for malignancy or rupture.

TRUE

What is the CP for adenomas? (include pt population)

CP: m/c asymptomatic women

- RUQ palpable mass, pain, shock (tumour rupture and hemoperitoneum).

What other tests can be done for adenomas?

Other tests: TSC - cold spot, CT, MRI, CEUS.

What are the SF for adenomas?

SF: solitary, solid, vascular

- inc size = complex

What is an angiomyolipoma?

Angiomyolipoma: lesion that contains blood vessel, muscle, fat.

TRUE or FALSE: Lipomas and angiomyolipoms have malignant potential.

FALSE: They have NO malignant potential

What conditions are associated with lipomas/angiomyolipomas (HINT: 2)

Associated w/ renal angiomyolipomas and tuberous sclerosis

What is the CP for lipomas/angiomyolipomas?

Asymptomatic.

What are the SF of lipomas & angiomyolipomas?

SF:

- solid

- well-defined, echogenic

- causes speed error artifact.

What benign liver tumour causes the speed error artifact?

Lipoma/angiomyolipoma

What benign liver tumour can also be assessed via RBC scintography?

Hemangioma