Management of 155 patients with benign liver tumours

Benign hepatic tumours continue to represent a diagnostic and therapeutic c hallenge. This study evaluates the indications and results of resection com pared with observation in patients with benign hepatic tumours. Patients with a primary diagnosis of benign liver tumour were identified fr om a prospective database and evaluated retrospectively. From January 1992 to June 1999, 155 patients with benign hepatic tumours we re evaluated. The diagnoses included haemangioma (n = 97), focal nodular hy perplasia (FNH) (n = 42), hepatic adenoma (n = 12) and cystadenoma (n = 4). Sixty-eight patients (44 per cent) underwent resection because of symptoms (n = 36), inability to exclude a malignancy (n = 31) or enlargement on ser ial imaging (n = 11). The operative morbidity and mortality rates were 21 p er cent and zero respectively. Thirty patients had a preoperative percutane ous needle biopsy, 19 of which were either incorrect or indeterminate. Over all, 39 of 42 patients with symptoms attributed to the tumour were asymptom atic after resection and 18 of 21 patients with symptoms considered unrelat ed to the tumour were asymptomatic after a period of observation and/or tre atment of unrelated conditions (median follow-up 16 months). When indicated, resection of benign liver tumours can be performed safely. Symptomatic patients with a small FNH or haemangioma can be observed becaus e their symptoms are unlikely to be related to the liver tumour. Percutaneo us needle biopsy rarely changes management.