Liver Lesions: What You Need to Know

Medically Reviewed By Megan Soliman, MD
Was this helpful?
11

Liver lesions are tumors or growths in the liver. Doctors often find them during imaging exams for other concerns. Although they are not typical, they are not necessarily dangerous. In fact, benign or noncancerous liver lesions are fairly common. Most of these liver lesions will not require treatment.

In some cases, liver lesions are signs of other problems. For example, they may indicate liver cancer or certain noncancerous problems, such as polycystic kidney disease.

This article explores liver lesions, including what they may mean and how doctors find and diagnose them.

What are liver lesions?

Liver lesions include various types of growths and tumors that develop in the liver. Most people do not experience symptoms, so they are unaware of their presence.

This is true even for cancerous lesions. Symptoms typically do not develop until the cancer has advanced.

Liver lesions can be focal, meaning that they appear as an isolated growth in an area of the liver. They can also be diffuse and spread out through the liver.

What are the types of liver lesions?

The main way to classify liver lesions is by their cancer status. They are either benign (noncancerous) or malignant (cancerous).

Benign or noncancerous types

In most cases, liver lesions turn out to be benign. Many benign lesions do not require treatment. However, this is not always the case. 

Types of benign liver lesions include: 

  • Fibromas: These are fibrous tumors in the liver. They are relatively rare.
  • Focal nodular hyperplasia: This is a lesion with a central scar. This lesion most commonly affects females. It usually does not cause any symptoms or require treatment.
  • Granulomas: These are collections of inflammatory cells. They do not usually cause symptoms. However, their presence may indicate an underlying condition that needs treatment.
  • Lipomas: These are tumors that consist of fat. They do not usually cause symptoms. Like fibromas, they are rare.
  • Liver abscess: This is a pus filled growth. It requires treatment.
  • Liver adenoma: These tumors can look like liver cancer. For this reason, it is important to get an accurate diagnosis. They most often affect younger females who use hormonal birth control. It is possible but rare for these tumors to become malignant. Treatment may or may not be necessary.
  • Liver cysts: These are very common and mainly affect females. They can occur as a single cyst or as multiple ones. Treatment is rarely necessary, but there are some types that require treatment, such as hydatid cysts. These come from the parasitic tapeworm Echinococcus granulosus.
  • Liver hemangiomas: These are vascular tumors. They are the most common type of benign liver lesion. They mainly occur in females, do not usually cause symptoms, and rarely need treatment.

There are also some reports of fungal infections presenting as tumor-like lesions in the liver. This further highlights the need for proper evaluation.

Malignant or cancerous types

Cancerous liver lesions are less common but more serious. They can be either primary or secondary cancers. Primary cancers start in the liver, while secondary liver cancer starts elsewhere in the body and spreads to the liver. 

Types of malignant lesions include:

  • Angiosarcoma and hemangiosarcoma: These are types of cancer that start in the lining of the blood vessels. This primary form of liver cancer is rare.
  • Hepatoblastoma: This is a very rare primary liver cancer that affects children.
  • Hepatocellular carcinoma: This is the most common form of primary liver cancer. It can occur as a single tumor or as many smaller tumors throughout the liver.
  • Intrahepatic cholangiocarcinoma: This accounts for up to 20% of primary liver cancers. It starts in the lining of small bile ducts.
  • Metastatic liver cancer: This is secondary cancer. It can spread from sites such as the breast, colon, or lung. Secondary liver cancer is more common than the primary forms in the United States.

How do doctors find and diagnose liver lesions?

Doctors often find liver lesions incidentally. A common scenario is a person undergoing an imaging exam for another medical reason.

In most cases, doctors can classify the lesions using laboratory tests and imaging exams. In a few cases, a biopsy will be necessary to properly diagnose the lesion. A biopsy takes a sample of liver tissue for microscopic examination.

Imaging exams for diagnosing liver lesions include:

  • Angiography: This visualizes the insides of the blood vessels and can also deliver chemotherapy to tumors.
  • CT scan: This makes cross-sectional images of the liver using radiation.
  • MRI scan: This also takes cross-sections, but it uses magnets instead of radiation.
  • Nuclear medicine scans: These include PET scans and single photon emission computed tomography scans, which use radioactive substances.
  • Ultrasound: This uses sound waves to produce images.

Blood tests that can help diagnose liver lesions and liver cancer include:

  • blood chemistry panels
  • blood clotting tests
  • complete blood counts
  • kidney function tests
  • liver function tests
  • tumor marker tests for liver cancer
  • viral hepatitis testing

What causes liver lesions?

There are various causes of liver lesions. However, many liver lesions have no identifiable cause.

Some potential causes of liver lesions include:

  • infections, including bacterial, fungal, parasitic, and viral infections
  • inflammatory conditions, such as sarcoidosis
  • medications, such as allopurinol and sulfonamides
  • oral birth control
  • viral hepatitis

Factors that may relate to cancerous liver lesions include:

What are the symptoms of liver lesions?

Most liver lesions are asymptomatic. People often do not realize that they have liver lesions because of this lack of symptoms.

If liver lesions become large, they can cause discomfort, fullness, or pain in the upper abdomen. Doctors may also be able to feel an enlarged liver.

Woman laying down with her arm over her stomach
Guillermo De La Torre/Stocksy United

Other possible signs and symptoms include:

How do doctors treat liver lesions?

The treatment options for liver lesions depend on the type and cause. Many benign lesions do not need treatment.

When symptoms occur or there is a risk of bleeding, a doctor may recommend treatment. Surgery is a common approach to benign lesions that are causing problems.

Liver cancer treatment depends on the stage of the cancer. For early cancers, surgery or transplantation may be options.

Other approaches include:

  • Ablation: This destroys liver tumors without removing them using ethanol or radio, microwave, or cold energy.
  • Chemotherapy: This can be systemic or local with an infusion into a liver artery.
  • Embolization: This involves injecting a substance into a liver artery to block blood flow to the tumor.
  • Immunotherapy: This uses medications that help a person’s own immune system fight the cancer.
  • Radiation therapy: This delivers a dose of radiation to help destroy cancer cells and shrink tumors.
  • Targeted therapy: This uses medications that target changes in liver cancer cells.

Is it possible to prevent liver lesions?

In general, liver lesions are not preventable. This includes liver cancer. However, there are some things you can do to keep your liver healthy.

For example, you can try:

  • avoiding hepatitis infections, such as by receiving all the recommended hepatitis vaccines and undergoing regular screenings
  • eating a healthy, balanced diet
  • limiting your alcohol intake
  • maintaining a moderate body weight
  • avoiding smoking
  • treating any liver diseases

Summary

Most liver lesions are benign, which means that they are noncancerous. The majority of people do not know that they have liver lesions because they do not cause any symptoms. It is common to find out that you have a liver lesion during an imaging exam you get for another reason.

In many cases, these incidental lesions do not need treatment. However, getting a proper diagnosis is vital. Sometimes, liver lesions turn out to be cancerous or have the potential to become cancerous. These lesions require follow-up and treatment.

Was this helpful?
11
Medical Reviewer: Megan Soliman, MD
Last Review Date: 2022 Apr 14
View All Liver Conditions Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.