Liver Mass Lesions

Liver mass lesions are a common diagnostic and management problem in clinical practice. Despite the myriad diagnostic possibilities (Table 1) and plethora of management approaches, the evaluation of these lesions is straightforward. This chapter emphasizes a clinical question-based approach useful in the evaluation of these lesions. The approach follows standard clinical practice routines and is easily adaptable to bedside practices. The overall goal of the clinician is to distinguish rapidly between benign and malignant lesions. In particular, the clinician wants to know if the lesion is a simple liver cyst, a cavernous hemangioma, focal fatty change, or focal nodular hyperplasia. Patients with these diagnostic entities can be given reassurance, and intervention or monitoring is not warranted. Other lesions, including abscesses, hepatic adenomas, cystadenomas, cholangiocarcinomas, hepatocellular carcinomas, and metastases, need either further investigation or other definitive treatment approaches.