What Are Liver Lesions?

A liver lesion is also called a liver tumor or mass

Liver lesion seen on imaging scan

mr.suphachai praserdumrongchai / iStock / Getty Images

Liver lesions are abnormal clumps of cells in your liver, and they are very common. They will be detected in as much as 30% of people over 40 who undergo imaging tests. The majority of liver lesions are benign (not harmful) and don't require treatment. But in some cases, liver lesions are malignant (cancerous) and should be treated.

Benign Liver Lesions

These are masses that form in the liver and don't typically cause health problems. They are non-cancerous and relatively common.

Types of Benign Liver Lesions

There are different types of benign liver lesions.

Hepatic Hemangioma

Hepatic hemangioma is the most common type of liver lesion, consisting of clusters of small blood vessels. Around 20% of the general population have hemangiomas. They don't typically cause symptoms, so they can be left untreated.

But In rare cases, they can cause stomach pain, nausea, and the inability to eat a full meal (early satiety). Women are more likely to have hemangiomas than men.

Focal Nodular Hyperplasia (FNH)

This is the second most common type of liver lesion. Like hemangiomas, FNH is seen more in women than men. In 80% of cases, FNH is found in women between the ages of 20 to 50. An FNH lesion can grow bigger or smaller, but regardless of changes to its size, it does not become cancerous.

Benign Hepatic Cyst

This type of lesion contains a clear, bile-like liquid and does not usually cause any symptoms. Although, in rare cases, if the cyst is large, it may cause abdominal pain or nausea, vomiting, and early satiety. Anywhere from 2.5% to 18% of the general population could have benign cysts in their liver.

Hepatic Adenomas

These are uncommon liver lesions that develop predominantly in young women. It can be caused by long term oral contraception use or synthetic testosterone use. Hepatic adenomas can sometimes cause discomfort in the abdomen.

About 5% of them will transform into hepatocellular carcinoma (HCC)—a type of liver cancer. More, in about 10% of cases, the lesion will spontaneously rupture or cause internal bleeding. This mostly happens during menstruation, pregnancy, and the postpartum period.

If you have hepatic adenomas, your doctor will likely ask that you stop taking oral contraceptives (if any). Surgery to remove them will probably also be prescribed.

Rarer types of benign liver lesions are hepatobiliary cyst adenoma, bile duct adenoma, and inflammatory pseudotumor.

Diagnosis

The diagnosis of benign liver lesions is usually accidental. Often, the lesions are detected when a patient undergoes magnetic resonance imaging (MRI) or other imaging tests for abdominal pain or an unrelated health problem. 

Other diagnostic tools may be used in cases where it is not clear from the imaging whether the lesion is benign or cancerous. For instance, cells from the tumor may be removed with a needle and sent to a lab for testing.

Treatment

Most of the time, these lesions do not cause any discomfort or health issues, and your doctor will likely recommend that they're left as is. In rare situations, these benign liver lesions may cause symptoms like stomach pain, nausea, and discomfort, and you may need surgery to remove them.

Some benign liver lesions may also have a high risk of rupture or transformation to cancerous tumors. In those cases, your doctor will likely recommend that they are surgically removed too.

Malignant Liver Lesions

Although most are benign, some liver lesions are cancerous.

Types of Liver Cancer

There are two major types of primary liver cancer (cancers that start in the liver):

  • Hepatocellular carcinoma (HCC): This is the most common type of liver cancer. HCC tumors are three times more common in men than women.
  • Fibrolamellar carcinoma: This is a subtype of HCC, where fibrous bands separate the cells of the tumor. In contrast with hepatocellular carcinoma, fibrolamellar carcinoma is seen more in women than men. And unlike HCC, its risk factors are not known.
  • Cholangiocarcinoma: This is the cancer of the bile duct. With cholangiocarcinoma, malignant liver lesions develop in the branches of the bile duct. These tumors can appear in the bile duct parts that are in the liver, or further down, in parts of the bile duct near the small intestine.

Rarer types of liver cancer include liver angiosarcoma and hepatoblastoma. Cancerous tumors that originate in other parts of the body can spread to the liver. And cancerous tumors that start in the liver can also spread to other parts of the body.

Symptoms

A cancerous liver lesion's main symptom is a hard lump or swelling in the area right below your rib cage on the right side. The lump itself is usually painless, but the area around it may or may not be painful.

Other liver cancer symptoms include jaundice, unintentional weight gain or loss, fever, nausea, vomiting, loss of appetite, and generally feeling unwell.

Risk Factors

Some of the risk factors for developing cancerous liver lesions include:

  • Hepatitis B or C infection: These viral infections are the leading causes of liver cancer.
  • Cirrhosis: Cirrhosis may be a precursor to liver cancer. It develops when long-term damage causes scar tissue build-up in the liver. Many factors can cause this damage, including excessive alcohol intake and hepatitis B or C infection. Liver lesions discovered in a person who has cirrhosis are most likely to be hepatocellular carcinoma.
  • Iron storage disease (hemochromatosis): This is a condition where the body stores excessive amounts of iron in the liver and other organs.
  • Sex: Men are more likely to have liver cancer than women
  • Aflatoxin exposure: Aflatoxin is a toxin that's produced by mold that grows on nuts and grains.

Diagnosis

Malignant liver lesions are diagnosed in a myriad of ways. If your doctor suspects you have liver cancer, any of these may be ordered:

  • Blood tests like alpha-fetoprotein (AFP) tumor marker and liver function tests (LFTs)
  • Imaging tests like ultrasounds, computerized tomography (CT) scans, and MRIs
  • A biopsy, which involves surgically removing some tissue or cells from the tumor and sending it to a lab for further testing

Treatment

There are different options available to treat cancerous liver lesions:

  • Surgical removal of the tumor
  • Liver transplant
  • Ablation therapy
  • Embolization therapy, which involves cutting off blood supply to the cancer, so it "starves" and cannot grow.
  • Targeted therapy drugs
  • Chemotherapy
  • Immunotherapy

Prevention

Some tangible steps you can take to prevent liver cancer are:

  • Prevent hepatitis B or C infection by practicing safe sex and getting vaccinated against hepatitis (if you weren't already as a child).
  • If you already have hepatitis B or C, ask your doctor for treatments that can help reduce your risk of developing cirrhosis and liver cancer.
  • Limit your alcohol intake.
  • Quit smoking.
  • Learn about your family history, especially relating to liver issues.

A Word From Verywell

Liver lesions are usually nothing to worry about. Nevertheless, if you're experiencing unexplained abdominal pain or discomfort, or any of the symptoms of liver cancer, you should see your doctor. And if liver lesions are accidentally discovered during an imaging test, your doctor will be in the best position to recommend treatment or otherwise.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Gore R, Pickhardt P, Mortele K et al. Management of incidental liver lesions on CT: A white paper of the ACR Incidental Findings CommitteeJournal of the American College of Radiology. 2017;14(11):1429-1437. doi:10.1016/j.jacr.2017.07.018

  2. Assy N, Nasser G, Djibre A, Beniashvili Z, Elias S, Zidan J. Characteristics of common solid liver lesions and recommendations for diagnostic workupWorld J Gastroenterol. 2009;15(26):3217. doi:10.3748/wjg.15.3217

  3. Lantinga M. Evaluation of hepatic cystic lesionsWorld J Gastroenterol. 2013;19(23):3543. doi:10.3748/wjg.v19.i23.3543

  4. Ferrell L. Benign and malignant tumors of the liver. Surgical Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas. 2009:1291-1325. doi:10.1016/b978-141604059-0.50050-3