title: Focal liver lesions found incidentally.
abstract: Incidentally found focal liver lesions are a common finding and a reason for referral to hepatobiliary service. They are often discovered in patients with history of liver cirrhosis, colorectal cancer, incidentally during work up for abdominal pain or in a trauma setting. Specific points should considered during history taking such as risk factors of liver cirrhosis; hepatitis, alcohol consumption, substance exposure or use of oral contraceptive pills and metabolic syndromes. Full blood count, liver function test and tumor markers can act as a guide to minimize the differential diagnosis and to categorize the degree of liver disease. Imaging should start with B-mode ultrasound. If available, contrast enhanced ultrasound is a feasible, safe, cost effective option and increases the ability to reach a diagnosis. Contrast enhanced computed tomography should be considered next. It is more accurate in diagnosis and better to study anatomy for possible operation. Contrast enhanced magnetic resonance is the gold standard with the highest sensitivity. If doubt still remains, the options are biopsy or surgical excision.
authors.affiliation: Abdullah A Algarni, Abdullah H Alshuhri, Majed M Alonazi, Liver Unit, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia.
authors.forename: Abdullah A
authors.initials: AA
authors.lastname: Algarni
authors.affiliation: Abdullah A Algarni, Abdullah H Alshuhri, Majed M Alonazi, Liver Unit, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia.
authors.forename: Abdullah H
authors.initials: AH
authors.lastname: Alshuhri
authors.affiliation: Abdullah A Algarni, Abdullah H Alshuhri, Majed M Alonazi, Liver Unit, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia.
authors.forename: Majed M
authors.initials: MM
authors.lastname: Alonazi
authors.affiliation: Abdullah A Algarni, Abdullah H Alshuhri, Majed M Alonazi, Liver Unit, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia.
authors.forename: Moustafa Mabrouk
authors.initials: MM
authors.lastname: Mourad
authors.affiliation: Abdullah A Algarni, Abdullah H Alshuhri, Majed M Alonazi, Liver Unit, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia.
authors.forename: Simon R
authors.initials: SR
authors.lastname: Bramhall
keywords: B-mode ultrasound; Computed tomography; Fine needle biopsy; Focal liver lesions; Magnetic resonance; Ultrasound