Liver Lesions: Causes, Symptoms, Types, And Treatment

You may have recently had the results of an MRI or CT scan indicating the presence of a lesion on your liver. Liver lesions are not uncommon, and while some may be indicators of a serious health condition or disease, other lesions may not be harmful and require no treatment.

What are liver lesions?

A liver lesion is a group of cells that collect in the liver. The abnormal cells can form a mass, cyst, or tumor, which can be either cancerous or benign.

When a lesion is discovered as part of a routine investigation and the person has no symptoms of liver problems, the lesion is more likely benign. However, even liver lesions that cause symptoms may be due to a non-cancerous liver condition or liver disease rather than cancer.

Symptoms of liver lesions

Not all liver lesions cause symptoms. Benign liver lesions commonly cause no symptoms and may have little to no impact on your health. However, symptoms may develop when the mass is large, possibly due to a liver condition or liver cancer.

Possible symptoms of liver lesions include:

• Abdominal pain

• Stomach bloating

• Loss of appetite or feeling full quickly

• Fever

• Feeling tired

• Weight loss

• Yellowing of the skin, jaundice

What causes liver lesions?

Lesions on the liver can occur due to various medical conditions, exposure to certain substances, or genetic factors. If a person experiences symptoms, their doctor may order imaging tests that later reveal lesions on the liver.

However, if a person has no symptoms, they only become aware of the lesions incidentally after an imaging test or examination for another condition or ailment.

Benign liver lesions

A non-cancerous liver lesion can occur for different reasons. Benign liver lesions are not commonly a threat to health and, in many cases, may not require medical treatment or intervention unless they are causing uncomfortable symptoms or becoming too large.

Types of benign liver lesions include:

• Liver cysts

• Hepatocellular adenoma

• Cystadenoma

• Hepatic hemangioma

• Focal nodular hyperplasia

Malignant liver lesions

Unlike benign liver lesions that do not often interfere with a person's health or life, a malignant liver lesion is cancerous and requires medical attention and intervention.

Although liver cancer is a rare condition in the US, over 36,000 men and women are still diagnosed with the disease each year. Malignant liver lesions may begin within the liver itself, as with hepatocellular carcinoma, or could occur due to metastasis from other cancers spreading to the liver.

Types of liver cancer

• Metastasis: A type of cancer that spreads to the liver over time and can cause lesions and damage to the liver. Treatment may involve treating the lesions in combination with treating original cancer.

• Hepatocellular carcinoma: This cancerous liver lesion begins within the liver and grows over time. The symptoms in the early stages may be subtle and could worsen as the cancer cells multiply.

Who is at risk of liver lesions?

Factors that can contribute to your risk of developing liver lesions include:

• Genetic makeup

• Environmental exposure

• Certain medications

• Lifestyle choices

However, it’s possible to develop liver lesions or liver cancer without any of the delineated risk factors.

Having a risk factor does not mean you will definitely get liver cancer, but it does increase your risk of developing the condition. The risk of cancerous liver lesions increases if you have more than one of the following risk factors:

• Prior hepatitis infection leading to liver damage; Hepatitis B and Hepatitis C carry the highest risk

• Cirrhosis of the liver from alcohol use, liver disease, or infection

• Prolonged and heavy alcohol use

• Smoking

• Certain genetic factors and hereditary conditions

How are liver lesions diagnosed?

Many people who discover a liver lesion do so by chance through routine imaging or when being medically examined for another reason. However, if you are experiencing symptoms relating to your liver, your doctor may refer you for tests to investigate the cause.

Types of tests to diagnose liver lesions include:

• Blood tests: Your blood can help doctors evaluate your liver function and whether something is affecting your liver's health. While a blood test will not reveal liver cancer, it can indicate a loss of function, leading to more in-depth testing.

• Diagnostic imaging: Many accidental discoveries of liver lesions occur when imaging procedures are conducted for other purposes. A doctor, however, may send you for an ultrasound, MRI, or CT scan of your abdomen if they suspect your liver may be the culprit of your symptoms.

• Biopsy: If a liver lesion is detected and there is uncertainty as to whether or not it may be malignant (cancerous), a doctor may perform a biopsy for evaluation. A biopsy is when a sample of your liver tissue is retrieved and tested to confirm or rule out malignancy.

Is it possible to prevent the development of liver lesions?

While you cannot change a genetic marker or predisposition to developing liver lesions, there are steps you can take to lower your risk of liver disease or liver cancer. To lessen your risk of developing malignant liver lesions, take a proactive approach to reduce the potential of liver damage from infection, substances, or your environment.

You can lower your risk of liver cancer by:

• Reducing or eliminating alcohol consumption

• Quitting smoking

• Managing your weight

• Maintaining a healthy diet

• Engaging in routine exercise

• Vaccinating against Hepatitis B infection

• Protecting yourself from contracting Hepatitis C

How are liver lesions treated?

Not all liver lesions will require treatment. If your doctor determines your liver lesions are benign and have no impact on your health or are not causing symptoms, it’s likely no intervention will be necessary unless changes occur.

However, if a liver lesion is symptomatic or malignant, it will need treatment depending on the extent and severity of the condition.

Treatment options for liver lesions can include:

• Ablation: This technique involves a targeted approach to destroying the cancerous cells within a tumor without removing the tumor or liver tissue. It is most effective when tumors are small.

• Surgery: Removal of the tumor or the portion of the liver affected by the malignancy is often the first course of treatment for liver cancer.

• Radiation: Targets cancer cells with high-energy rays to kill the cells. Radiation is common in cases where cancer has metastasized and/or surgery is not possible.

• Drug therapy: Certain drugs may help inhibit the growth and spread of cancer cells in the liver and the body.

• Chemotherapy: Doctors may recommend chemotherapy when other treatment options are not possible for a patient or unlikely to succeed. Chemotherapy works to target and kill cancer cells throughout the body, making it a likely option when liver cancer has spread.

• Immunotherapy: Unlike drug therapy, which uses medications to target cancer cells directly, immunotherapy provides an opportunity for medicines to boost the body's defenses against cancer cells from your own immune system.

• Embolization therapy: This technique involves restricting the blood flow to the liver, which feeds into the growth of a tumor. Over time, this can help to kill the cancer cells and, in turn, the tumor.

The lowdown

Many people are living with liver lesions, but in some cases, these lesions are benign and not a cause for serious concern.

However, if you have symptoms that you or your doctor believe may be due to your liver, you should go forward with testing to determine whether a liver lesion is causing your symptoms.