Indication for liver biopsy in hepatic tumors

Significant progress has been made in the assessment of liver dysfunction b y application of non-invasive physical and biochemical test procedures. How ever, liver biopsy remains an important tool for diagnosis, evaluation and prognosis of chronic liver diseases and hepatic neoplasms. Liver biopsy res ults are most useful when the biopsy is performed for well-defined indicati ons following a complete work-up of the patient. In case of lesions highly suspicious for hepatocellular carcinoma, a biopsy should be performed in ca se surgical (curative) treatment is no option. Thus for the planning of a s urgical intervention, biopsy of the tumor is not necessary. In case of conc omitant liver cirrhosis, a biopsy taken from the non-neoplastic (cirrhotic) liver may help to assess the functional capacity or to clarify the etiolog y. Metastases of the liver with unknown primary tumor should be biopsied to obtain information of the primary tumor and the potential for cytostatic t herapy. In case of hemangioma or focal nodular hyperplasia, diagnosed and c onfirmed by radiology or ultrasound, biopsy is usually not necessary. Conce rn has been expressed about seeding of the needle tract with malignant cell s. Indeed, such instances have been recorded with various carcinomas, but t hey remain rare events and are seldom of clinical importance. With the use of needles with diameter < 1.3 mm to minimise also the risk of bleeding, th e procedure is simple, safe and painless.