Liver Lesions

Key points

• Benign liver lesions are non-cancerous growths or lumps in the liver
• They are very common and are usually found when a scan is done for another reason
• Benign liver lesions can be caused by lots of different conditions
• They don’t spread to other parts of the body and often don’t need treatment
• Your doctor will want to make sure the growth isn’t cancer

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What are benign liver lesions?

You can have different types of growths in the liver. They might not have any symptoms. Often they don’t need to be treated.

Sometimes you can be born with liver lesions. Sometimes they develop as you get older. Over the age of 40, about 1 in 3 people are thought to have a liver lesion.

Some different types of benign liver lesions are:

Benign solid growths

Benign means not cancer. So these are growths aren’t cancer and won’t spread to other parts of the body.

You might discover you have a benign liver tumour when you have a scan for something else.

Types of benign solid growths in the liver include:

Haemangioma: A haemangioma is a growth made up of abnormal blood vessels. They may grow to about 5cm but occasionally they are huge. Haemangiomas are quite common and affect about 1 in 20 people. They won’t spread or turn into cancer, and most people don’t need any treatment. But if you have a haemangioma that is very large it can press on blood vessels and may need to be removed.

Focal nodular hyperplasia (FNH): This is a small lump, usually about 3cm to 5cm, that is due to overgrowth of liver cells around an abnormal artery. It is most common in women aged 15 to 50. It won’t burst or spread. It is not thought to be related to hormones. Occasionally there may be more than one FNH in the liver.

Adenoma: An adenoma is an abnormal lump of cells. Adenomas can grow anywhere in the body including in the liver. Adenomas in the liver can grow quite big (up to 15cm) and can burst, so they often need to be removed. Sometimes there may be more than one adenoma present. Adenomas might grow due to hormones, such as oestrogen used for contraception or during pregnancy in women, or anabolic steroids in men. They are also more common in people with obesity. Adenomas that occur in men are at higher risk of turning into cancer and surgery is usually recommended.

Liver cysts

A cyst is a sac filled with fluid. Cysts can be tiny or grow very large. Different types of cysts can grow in the liver.

Simple liver cyst: Simple liver cysts are quite common. You might be born with them or develop them as an adult. They shouldn’t cause you any problems and they don’t turn into cancer. But if they grow big, they might cause discomfort or block the bile duct. In this case they can be drained.

Polycystic liver disease: This is a rare inherited condition where lots of cysts of different sizes grow throughout the liver. There may also be lots of cysts in the kidneys. Often other members of the family also have polycystic disease of the liver or kidneys. The cysts can look like bunches of grapes. Polycystic liver disease can cause the liver to become very large and uncomfortable, but it doesn’t usually affect liver function. In rare cases, medicine or surgery is needed. Very rarely, people with very severe disease might need a liver transplant.

Choledochal cysts: These are cysts that form in the bile ducts. They are most common in children, although sometimes they’re not found until adulthood. They can cause build-up of bile in the liver, leading to yellow skin and eyes (jaundice), inflamed pancreas or gallbladder, or liver damage. Some people with choledochal cysts develop a rare type of cancer called cholangiocarcinoma. The cysts can be removed in surgery.

Hyatid cysts: Hyatid disease is rare. It happens when you’re infected with a tapeworm which can be caught from eating dog poo when the dog has been exposed to infected sheep or other animals. It causes cysts in the liver and other parts of the body. These can grow larger and form into a mass. They can block the blood flow, burst, or cause an allergic reaction. They can cause problems with the gallbladder or an infection. Hyatid cysts can be treated with medicine to kill the parasite, or surgery to remove the cysts.

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What are the symptoms of benign liver lesions?

Usually benign liver lesions don’t cause any symptoms. Most people only find out about them when they have an ultrasound for something else.

If you do have symptoms, they might include:

• Bloating
• Pain in your belly
• Feeling very full / not feeling hungry
• Large liver or spleen
• Nausea and vomiting
• Weight loss
• Feeling weak or tired
• Yellow skin or eyes (jaundice)

Read more about the symptoms of liver disease

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How are liver lesions diagnosed?

If your doctor is worried about your liver, they will order blood tests. These will look for enlargement of the liver, the presence of certain proteins, and how well your liver is working.

You may also need an ultrasound, CT, MRI or PET scan to take detailed pictures of the liver. A CT or MRI scan with an injection of dye is usually enough to decide whether a liver lump is benign or might be a cancer.

Your doctor will want to check the growth isn’t a sign of hepatocellular carcinoma or another form of liver cancer. If you have a liver lesion, you’re more at risk of liver cancer if:

• You have the hepatitis B or hepatitis C virus
• You have cirrhosis
• You have haemochromatosis
• You are living with obesity.

If there is a chance of cancer, you may need to have a liver biopsy, where a small sample is taken from the liver to look at under a microscope, or an operation to remove the lump.

Read more about liver tests

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Why did I get liver lesions?

Anyone can develop benign liver lesions. In most cases we don’t know why they grow. Adenomas may have clear risk factors such as:

• Birth control pills
• Anabolic steroids.

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How are benign liver lesions treated?

Benign liver lesions often don’t need any treatment. But if they get large or there’s a chance they can burst, you may need surgery. Surgery may be recommended in some people if there’s a possibility it’s cancer, or if there is an increased risk of developing cancer in the future.

Read more about liver treatments

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What next?

Read more about living well

 

Reviewed November 2022