Diagnosis and treatment of benign focal liver lesions.
BACKGROUND
With the routine use of improved imaging modalities, more benign liver lesions are detected nowadays. An accurate characterization of these incidental lesions may be a challenge, and frequently a biopsy or even unnecessary surgery is being performed. However, these interventions are not always to the benefit of the patient.


METHODS
A Medline search of studies relevant to imaging diagnosis and management of the most common, benign, solid and non-solid liver lesions was undertaken. References from identified articles were handsearched for further relevant articles. The authors' own experiences with benign liver lesions were also taken into account.


RESULTS
Although atypical imaging features are the exception rather than the rule, it is sometimes difficult to differentiate between benign and malignant lesions, and knowledge of their imaging features is essential if unnecessary work-up is to be avoided. The use of tissue-specific contrast media, which has clearly improved the accuracy of highly advanced radiological techniques, may be helpful during differential diagnosis. Once having established an accurate diagnosis, surgery is rarely indicated for a benign liver lesion because of its asymptomatic nature.


CONCLUSIONS
Knowledge of imaging features and a clear management strategy during diagnostic work-up, emphasizing the indications for surgery, will minimize the number of patients who have to undergo biopsy or unnecessary surgery.
Terkivatan
Türkan
T
Department of Surgery, Erasmus University Medical Center Rotterdam, The Netherlands.
Hussain
Shahid M
SM
De Man
Rob A
RA
Ijzermans
Jan N M
JN
D018248:Adenoma, Liver Cell / Q000175:diagnosis / Q000628:therapy; D018207:Angiomyolipoma / Q000175:diagnosis / Q000628:therapy; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000628:therapy; D004444:Echinococcosis, Hepatic / Q000175:diagnosis / Q000628:therapy; D004621:Embolization, Therapeutic; D020518:Focal Nodular Hyperplasia / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D006222:Hamartoma / Q000175:diagnosis / Q000628:therapy; D006392:Hemangioma, Cavernous / Q000175:diagnosis / Q000628:therapy; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*