Liver lesions are found in around 30% of people over the age of 40. Most liver lesions are harmless and do not cause other health problems. However, some types of lesions on the liver are cancerous, though they occur only in rare cases. Some liver lesions require treatment while others usually do not. Non-cancerous lesions on the liver generally do not require any treatment unless they grow large and painful, or cause other symptoms.
1. What is a lesion in the liver?
Lesions on the liver are groups of abnormal cells in your liver, which your doctor may refer to as a ‘mass’ or ‘tumor’. They may be cancerous (or malignant) or non-cancerous (or benign). Most of the times, liver lesions are harmless and do not spread to other areas of the body or cause other health issues. However, some liver lesions are formed as a result of liver cancer, which is rare.
2. What are the types of liver lesions?
The liver can be benign (non-cancerous) or malignant (cancerous). Some types of benign lesions require treatment, while others do not.
2.1. Benign Lesions where no treatment is required
Here is a list of benign lesions on the liver that typically do not require treatment.
2.1.1. Hepatocellular adenoma (HCA)
Hepatocellular adenoma, also known as hepatic adenoma or HCA, is a benign liver lesion that develops in otherwise healthy liver. This type of benign lesion is quite uncommon. Typically, these benign lesions are solitary and found in young women who use medications containing oestrogen. In addition, patients with glycogen storage disease or metabolic syndrome are at a higher risk of developing this lesion.
2.1.2. Hepatic/cavernous haemangioma
Hepatic haemangiomas are the most common mesenchymal tumors of the liver. These benign liver lesions hypervascular, venous malformations that occur in the liver. Hepatic haemangiomas are also known as cavernous or capillary hepatic haemangiomas. These liver masses are estimated to occur in about 20% of the population and exert no hazardous effects or damage on your adjacent organs.
2.1.3. Focal nodular hyperplasia (FNH)
These benign lesions are the second most common type of benign liver tumor and are more commonly found (82% to 91% of cases) in women, mostly between 20 to 50 years of age. Focal Nodular Hyperplasia (FNH) accounts for 8% of all primary liver tumors and 25% of those that are benign. Patients generally do not have any symptoms, but in rare cases, these tumors may cause epigastric or right upper quadrant pain. However, in case of men, FNH is diagnosed significantly later in life and more likely to be surgically removed as in these cases, though the lesions are smaller, they display more severe morphological atypia.
2.1.4. Hepatic cysts
Also referred to as simple liver cysts, hepatic cysts usually grow slowly and are not detected until adulthood. The cause of these benign cysts are not precisely known. They may be present at birth or develop later. Most liver cysts typically do not cause any symptoms, but if they grow large, they may cause symptoms like bloating and pain in the upper right part of your abdomen. Liver cysts generally do not require treatment but must be drained or surgically removed if they grow large and painful.
2.2. Benign Lesions that require treatment
The following benign liver lesions require treatment.
- Hepatocellular adenoma [symptomatic; >5cm complications (for example, rupture)]
- Hepatic cysts [symptomatic]
2.3. Malignant Lesions
Here is a list of malignant or cancerous liver lesions.
2.3.1. Hepatocellular carcinoma
Hepatocellular carcinoma or HCC is the most common type of primary liver cancer. This malignant lesion in the liver occurs most often in people who have chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection. However, about 25% of patients do not have a history of cirrhosis or risk factors associated to it. Men are more likely to develop hepatocellular carcinoma than women are. It causes around 12,000 deaths per year in the United States, which makes it one of the most serious cancers found in adults. Liver transplantation is the best option for people with HCC.
Cholangiocarcinoma is also known as bile duct cancer as it is a malignant lesion that forms in one’s slender tubes or bile ducts, which carry the digestive fluid bile. This type of cancer mostly occurs in people older than 50 years of age but it can occur in people of any age group. Cholangiocarcinoma can be classified into different types based on where the cancer occurs in the bile duct. These malignant lesions are often diagnosed in its advanced stages, making effective or successful treatment extremely difficult.
22.214.171.124. Intrahepatic cholangiocarcinoma
ICC is a rarely occurring malignant tumour that arises from the epithelial cells of intrahepatic bile ducts (or beyond the second-order bile ducts). The incidence of intrahepatic cholangiosarcoma has been reported to be about 10 per cent of all primary liver cancers. Patients generally do not experience symptoms in the early stages but they may experience a wide array of symptoms such as weight loss, malaise, abdominal discomfort, hepatomegaly or a palpable abdominal mass in more advanced stages.
126.96.36.199. Hilar cholangiocarcinoma
Hilangiocarcinoma, also called Klatskin tumors, is a type of bile duct cancer that occurs in the bile ducts that lead out of the liver (known as the hepatic ducts) and join with your gall bladder. It is a rare disease with a poor prognosis and typically occurs in people aged 60 or older. Symptoms are non-specific in the earlier stages. Common symptoms, that have however been found in only one-third of the patients, include abdominal pain or discomfort, anorexia, weight loss and pruritus.
188.8.131.52. Distal cholangiocarcinoma
DCC is an uncommon cancer and accounts for around 30–40% of all cases of cholangiocarcinomas. In case of distal bile duct cancer, patients usually manifest jaundice early in the course of disease and likely seek medical care prior to metastasis development. The typical presentation of this type of cancer is painless jaundice in patients who are in the 5th to 7th decade of their life. About 56% of patients with distal cholangiocarcinoma present with conventional such as anorexia, fatigue, and weight loss.
2.3.3. Liver metastases
Liver metastases, also sometimes called metastatic liver disease, refers to cancer that starts in one part of the body and later spreads to the liver. Liver metastases is much more common than primary liver cancer, which is cancer that starts in the liver. In most of the cases, cancer that has spread to one’s liver cannot be cured. However, certain treatments may help shrink tumors, improve the patient’s life expectancy, and relieve some symptoms.
2.3.4. Angiosarcoma (rare)
Angiosarcoma forms in the lining of the blood vessels and lymph vessels. This is also a rare type of cancer; most angiosarcoma can be cured by surgery alone but in case they have spread to other parts, they are hard to cure. The types of angiosarcoma include conventional angiosarcoma, epitheloid angiosarcoma, and angiosarcoma of bone.
2.3.5. Hepatoblastoma (seen in children within the first three years of life)
Hepatoblastoma, though rare, is the most common type of malignant tumour found in small children. This type of cancer primarily affects children from infancy to about 5 years of age and affects white children more frequently than black children. Also, it is more common in boys than girls up to 5 years of age. In addition to this, hepatoblastoma occurs more frequently in children born premature with very low birth weights.
3. What causes lesions on the liver?
A variety of reasons can cause lesions in the liver, though the exact reasons for the development of some liver lesions are still unknown. Here are some possible reasons.
- Lesions in the liver may develop as a result of scarring (cirrhosis) from chronic liver disease, which occurs in case of hepatitis B, hepatitis C and in heavy drinkers.
- Heavy smoking may induce necroinflammation and increase the severity of hepatic lesions (fibrosis and activity scores) when associated with hepatitis C virus (HCV) or hepatitis B virus (HBV) infection.
- Hormones used in birth control pills, especially estrogens, may promote the growth of benign liver tumours, such as focal nodular hyperplasia, hemangiomas, and hamartomas. Hepatocellular carcinoma has also been linked to the use of oral contraceptives in numerous case reports.
4. What symptoms do liver lesions cause?
Symptoms caused by liver lesions vary on the basis of the type of lesion you have in your liver.
4.1. Symptoms of benign or non-cancerous liver lesions
Benign lesions, especially when they are small in size, generally do not cause any symptom at all. But if they grow to the extent to put pressure on nearby organs, which happens only in rare cases, these benign or non-cancerous liver lesions may cause abdominal pain.
4.2. Symptoms of malignant or cancerous liver lesions
Liver cancer does not generally show symptoms until it has progressed to its later stages. In those later stages, as the lesion grows, patients start experiencing some symptoms. These include fatigue, pain in the abdomen, yellowing of skin and eyes (white part) due to jaundice, feeling of a lump towards the top right side of the stomach, loss of appetite and feeling full after eating very less quantity of food, and white, chalky stools.
5. What are the foods that we should avoid to keep our livers healthy?
The liver finds certain types of food harder to process than others. These foods should be avoided as much as possible for good liver health. Here is a list of some such foods.
5.1. Fatty foods
Foods high in fat need to be avoided to keep the liver healthy. Fatty foods include fried foods, fast food meals, and takeout meals. In addition to these, packaged snacks and chips are also very high in fat and should be avoided as much as possible.
5.2. Starchy foods
Starchy foods are also harder for your liver to digest. These foods include low-fiber, highly processed white bread, pasta, white rice, and baked goods. Consumption of starchy food should be kept to a minimum to maintain good liver health.
Cut down on sugar and foods containing high quantities of sugar to keep your liver healthy. Sugary foods include cereals, baked goods, and candies. Reducing the consumption of sugar and sugary foods will help reduce stress on the liver.
Salt intake is bad for our liver as a diet high in salt decreases the liver’s antioxidant defences. To reduce salt consumption, you need to eat out less often, choose canned meats or vegetables that are low in sodium, and reduce or avoid salted deli meats and bacon as much as you can.
Each time you drink, your liver filters alcohol and some of the liver cells die. Though the liver is able to generate new cells, continued alcohol misuse or drinking too much for several years can reduce your liver’s ability to regenerate, which can lead to serious and permanent damage to your liver. Alcohol contributes to at least half of all severe trauma injuries and deaths from burns, drownings, and homicides. It is one of the common causes of liver problems like fatty liver, cirrhosis, and other issues. To keep your liver healthy, you should stay away from alcohol. Though quitting is the best option, even cutting back on drinking will lower levels of your BP and triglycerides and reduce chances of heart failure.
Our liver has several essential functions: it absorbs and breaks down nutrients, makes bile (a fluid that helps digest fats), filters and removes toxic substances from blood, and produces proteins that help stop bleeding from a cut or injury. Therefore, we must keep our liver healthy. Coffee, green tea, nuts, grapes, berries and oatmeal are great for your liver. Fatty fish, which contain omega-3 fatty acids, are also good for your liver and heart. Fatty fish include tuna, sardines, herring, trout and mackerel, to mention a few. You should also stay away from drinking, as alcohol consumption is detrimental to your liver health.