Liver

The liver processes nutrients, produces bile and proteins, and clears many substances from the body. Liver lesions can be benign or malignant, and many are discovered incidentally on a scan done for another reason. Accurate diagnosis relies on good-quality imaging and, when needed, discussion within a multidisciplinary team of surgeons, hepatologists, radiologists and oncologists.

Liver cysts

What it is: Simple liver cysts are fluid-filled spaces within the liver. They are common, almost always benign and usually need no treatment.

Symptoms: Most cause no symptoms. Large cysts may cause upper abdominal fullness, discomfort or early satiety.

Treatment: Observation is usually enough. Symptomatic or uncertain cysts may be treated with laparoscopic fenestration (deroofing) or, when a cystic tumour is suspected, surgical removal.

Hydatid (echinococcal) cyst

What it is: A parasitic infection caused by the larval stage of the Echinococcus tapeworm, usually acquired through contact with infected dogs or contaminated food or water.

Symptoms: Often silent for years. It may cause pain, a palpable mass, jaundice, infection or, rarely, rupture with allergic reactions.

Treatment: Antiparasitic medication combined, in selected cases, with surgical removal of the cyst or percutaneous drainage techniques.

Liver haemangioma

What it is: The most common benign liver tumour, made of a tangle of blood vessels.

Symptoms: Usually none. Very large lesions can occasionally cause pain or pressure symptoms.

Treatment: Most need no follow-up once the diagnosis is certain. Surgery is reserved for symptomatic, growing or diagnostically uncertain lesions.

Focal nodular hyperplasia and hepatocellular adenoma

What it is: Focal nodular hyperplasia (FNH) is a benign nodule with no malignant potential. Hepatocellular adenoma is a benign tumour often linked to hormonal factors such as oral contraceptives, and some subtypes can bleed or rarely become malignant.

Symptoms: Usually found incidentally. Adenomas may occasionally cause pain or bleeding.

Treatment: FNH rarely needs treatment. Adenomas are assessed by size and subtype on MRI; larger or higher-risk adenomas may be removed, often laparoscopically.

Liver abscess

What it is: A collection of pus within the liver, most often due to bacteria spreading from the bile ducts or the bowel.

Symptoms: Fever, rigors, right upper abdominal pain and feeling generally unwell.

Treatment: Antibiotics together with image-guided drainage in most cases. The underlying source, such as gallstones or diverticular disease, is also treated.

Hepatocellular carcinoma (HCC)

What it is: A primary cancer arising from liver cells, most often in a liver affected by cirrhosis, chronic hepatitis B or C, alcohol or fatty liver disease.

Symptoms: Frequently none in early stages, which is why surveillance of high-risk patients matters. Later it may cause pain, weight loss or jaundice.

Treatment: Depending on tumour stage and liver function: liver resection, ablation, transplantation, transarterial chemoembolisation or systemic therapy.

Intrahepatic cholangiocarcinoma

What it is: A cancer that arises from the small bile ducts inside the liver.

Symptoms: Often vague: abdominal discomfort, weight loss or abnormal liver blood tests, sometimes found on imaging.

Treatment: Surgical resection offers the best chance of cure when feasible, frequently followed by chemotherapy. Advanced disease is treated with systemic therapy.

Liver metastases

What it is: Cancer that has spread to the liver from another organ, most commonly the colon or rectum, and also from neuroendocrine and other tumours.

Symptoms: Often detected on staging or follow-up scans before any symptoms appear.

Treatment: In selected patients, especially with colorectal metastases, liver resection or ablation combined with chemotherapy can offer long-term survival or cure. Treatment is planned by the multidisciplinary team.

How assessment is organized

Assessment begins with your history, blood tests and imaging, usually multiphase CT or liver MRI. Depending on the findings, tumour markers, PET-CT, biopsy or an assessment of liver volume and function may be needed before surgery. Recommendations are made after reviewing all results, and often after multidisciplinary discussion.

This information is general and does not replace individual medical assessment.