Benign focal liver lesions-from diagnosis to treatment

Focal liver lesions in a noncirrhotic liver often present as incidental finding during routine abdominal imaging as part of a general check-up, or during work-up in case of a known malignancy. Only in some cases, liver tumors may be symptomatic. The most important diagnostic challenge involves differentiating benign tumors from pre-malignant or malignant lesions. Especially during work-up of a known malignancy a correct diagnosis of a liver lesion is essential for an adequate staging, thereby preventing an over-, or undertreatment of malignant disease. However, there are still patients who do undergo unnecessary biopsy or surgery because of a presumed malignancy or because of uncertainty in the diagnosis despite an extensive work-up. However, these interventions are not always to the benefit of the patient. Even after having diagnosed a benign lesion, the most appropriate treatment still may remain controversial, as in case of a hepatocellular adenoma. This thesis emphasizes the need for a clear management strategy in case of a presumed benign liver lesion, and formulates guidelines for diagnostic work-up and the indications for surgery.

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