title: Solitary liver lesions of indeterminate malignancy--outcome following surgical resection.
abstract: BACKGROUND
  Well-differentiated hepatocellular carcinoma (HCC) may resemble benign liver lesions on initial diagnostic work-up. The validity of surgical resection for preoperatively unclear liver lesions was investigated in this study.
  
  
  METHODS
  We conducted a retrospective analysis of 483 patients subjected to liver resection over a 15-year period.
  
  
  RESULTS
  Forty-five patients (9%) were considered to have presented with indeterminate solitary lesions. There were 18 cases of HCC (40%) and 27 cases (60%) of benign lesions, most commonly focal nodular hyperplasia (n=18). Patients with HCC had a higher median age as compared to patients with benign pathology (67 vs. 55 years; p=0.002) and the median tumor size was larger (85 vs. 30 mm; p=0.007). Major complications (Clavien grade III or higher) occurred in three cases (7%) and there was no in-hospital mortality.
  
  
  CONCLUSIONS
  The results favor an aggressive approach, i.e. surgical intervention, to patients presenting with indeterminate solitary liver tumors due to the high likelihood of an underlying HCC.
authors.affiliation: Department of Surgery, Clinical Sciences Lund, Skåne University Hospital and Lund University, Lund, Sweden.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ansari
authors.forename: Gunnar
authors.initials: G
authors.lastname: Nordqvist
authors.forename: Peter
authors.initials: P
authors.lastname: Hammarlund
authors.forename: Josef
authors.initials: J
authors.lastname: Dankiewicz
authors.forename: Ammar
authors.initials: A
authors.lastname: Massoud
authors.forename: Roland
authors.initials: R
authors.lastname: Andersson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D012189:Retrospective Studies