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Differential Diagnosis of the Liver Mass

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General Surgery

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Pearls and Pitfalls

  • Currently, most liver masses are asymptomatic and are identified incidentally during survey for chronic liver diseases or other purposes.

  • Many liver masses occur in cirrhotic livers secondary to chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections.

  • Abdominal ultrasonography is the most convenient imaging modality to screen patients at risk for liver masses and will differentiate cystic from solid tumors.

  • Dynamic computed tomography (CT) is recommended to assess the liver tumor and remainder of the abdominal cavity simultaneously.

  • CT, magnetic resonance imaging (MRI), and angiography can be valuable and complementary in the evaluation of liver masses.

  • Tumor markers, such as α-fetoprotein (AFP), carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9), may help to narrow the differential diagnosis.

  • Positron emission tomography (PET) has not proven useful or cost-effective for differentiating most liver masses.

  • Liver biopsy is...

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Selected Readings

  • Gibbs JF, Litwin AM, Kahlenberg MS (2004) Contemporary management of benign liver tumors. Surg Clin N Am 84:463–480

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  • Hammerstingl RM, Schwarz W, Vogl TJ (2003) Contrast agents. In: Vogl TJ, Lencioni R, Hammerstingl RM, Bartolozzi C (eds) Magnetic resonance imaging in liver disease. Georg Thieme Verlag, Stuttgart/New York, pp 45–91

    Google Scholar 

  • Lee WC, Jeng LB, Chen MF (2002) Estimation of prognosis after hepatectomy for hepatocellular carcinoma. Br J Surg 89:311–316

    Article  PubMed  Google Scholar 

  • Lee WC, Jeng LB, Chen MF (2000) Hepatectomy for hepatitis B-, hepatitis C-, and dual hepatitis B- and C-related hepatocellular carcinoma in Taiwan. J Hepatobiliary Pancreat Surg 7:265–269

    Article  PubMed  CAS  Google Scholar 

  • Yeh CN, Lee WC, Chen MF, Tsay PK (2003) Predictors of long-term disease-free survival after resection of hepatocellular carcinoma: two decades of experience at Chang-Gung Memorial Hospital. Ann Surg Oncol 10:916–921

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of General Surgery, Chang-Gung Memorial Hospital and Chang-Gung University Medical School, Taoyuan, Taiwan

    Wei-Chen Lee

  2. Department of Surgery, Chang-Gung Memorial Hospital, 5, Fu-Hsing Street, Kwei-Shan Hsiang, Taoyuan, Taiwan

    Miin-Fu Chen

Authors
  1. Wei-Chen Lee
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  2. Miin-Fu Chen
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Editor information

Editors and Affiliations

  1. Department of Surgery, Deputy Director, Comprehensive Cancer Center University of Alabama School of Medicine, Birmingham, AL, USA

    Kirby I. Bland MD (Fay Fletcher Kerner Professor and Chairman) (Fay Fletcher Kerner Professor and Chairman)

  2. Department of General and Visceral Surgery, University of Heidelberg, Heidelberg, Germany

    Markus W. Büchler MD (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

  3. Department of Surgery, University Hospital, Santiago, Chile

    Attila Csendes MD, FACS (Hon) (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

  4. James C. Mason Professor of Surgery Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

    Michael G. Sarr MD

  5. Department of Clinical and Surgical Sciences, The University of Edinburgh Royal Infirmary of Edinburgh, Edinburgh, UK

    O. James Garden MBChB, MD, FRCS (Ed), FRCP (Ed), FRACS (Hon) (Regius Professor of Clinical Surgery) (Regius Professor of Clinical Surgery)

  6. Department of Surgery, The University of Hong Kong Queen Mary Hospital, Hong Kong, China

    John Wong BSc (Med (Syd)), MBBS (Syd), PhD (Syd), MD (Hon (Syd)), FRACS, FRCS (Edin), FRCS (Glasg), FACS (Hon) (Chair Professor) (Chair Professor)

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© 2009 Springer Science+Business Media, LLC

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Lee, WC., Chen, MF. (2009). Differential Diagnosis of the Liver Mass. In: Bland, K.I., Büchler, M.W., Csendes, A., Sarr, M.G., Garden, O.J., Wong, J. (eds) General Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-833-3_93

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  • DOI: https://doi.org/10.1007/978-1-84628-833-3_93

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-832-6

  • Online ISBN: 978-1-84628-833-3

  • eBook Packages: MedicineReference Module Medicine

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