Background:Due to the frequent use of medical imaging including ultrasonography, the
incidence of benign liver tumors has increased. There is a large variety of different
solid benign liver tumors, of which hemangioma, focal nodular hyperplasia (FNH), and
hepatocellular adenoma (HCA) are the most frequent. Advanced imaging techniques allow
precise diagnosis in most of the patients, which reduces the need for biopsies only
to limited cases. Patients with benign liver tumors are mostly asymptomatic and do
not need any kind of treatment. Symptoms can be abdominal pain and pressure effects
on adjacent structures. The 2 most serious complications are bleeding and malignant
transformation.Summary:This review focuses on hepatic hemangioma (HH), FNH, and HCA,
and provides an overview on clinical presentations, surgical and interventional treatment,
as well as conservative management. Treatment options for HHs, if indicated, include
liver resection, radiofrequency ablation, and transarterial catheter embolization,
and should be carefully weighed against possible complications. FNH is the most frequent
benign liver tumor without any risk of malignant transformation, and treatment should
only be restricted to symptomatic patients. HCA is associated with the use of oral
contraceptives or other steroid medications. Unlike other benign liver tumors, HCA
may be complicated by malignant transformation. HCAs have been divided into 6 subtypes
based on molecular and pathological features with different risk of complication.Key
Message:The vast majority of benign liver tumors remain asymptomatic, do not increase
in size, and rarely need treatment. Biopsies are usually not needed as accurate diagnosis
can be obtained using modern imaging techniques.
