Hepatic Haemangioma
Overview
Hepatic haemangiomas are the most common benign liver tumours that are often found incidentally during investigations for other conditions.
They are thought to be congenital and do not generally cause any symptoms unless they become large, which can lead to pressure on nearby structures, causing right upper quadrant pain, abdominal fullness and early satiety, and compression of the biliary tree.
They are hyperechoic on an ultrasound scan.
Focal Nodular Hyperplasia
Overview
Focal nodular hyperplasia is the second most common benign liver tumour after hepatic haemangioma made of scar tissue. They are more common in women and are linked to the use of the combined oral contraceptive pill, suggesting a relation to oestrogen.
Often, an ultrasound scan is sufficient for diagnosis, but further confirmation may be needed using CT/MRI etc.
Liver Abscess
Overview
A liver abscess is a collection of pus inside the liver. The main types of liver abscesses are:
- Pyogenic liver abscess – most common cause in developed countries
- Most commonly caused by biliary disease (e.g. infection/trauma/surgery), appendicitis, diverticulitis, and Crohn’s disease
- Often polymicrobial and includes Staphylococcus aureus and Escherichia coli
- Amoebic liver abscess due to Entamoeba histolytica – more common in developing countries
- Aspiration may yield fluid that has a similar consistency to anchovy sauce
General features include fever, right upper quadrant pain, and jaundice may develop in some cases.
An ultrasound scan may show a fluid-filled cavity and may show hypoechoic walls in chronic abscesses.
Cysts due to Polycystic Kidney Disease
Overview
Liver cysts are the most common extra-renal manifestation of autosomal dominant polycystic kidney disease. They do not typically cause liver failure and are asymptomatic, however, if large enough, they can cause problems due to mass effects such as abdominal pain.
