Internal Medicine

0521779407-B01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:52

232 Benign Prostatic Hyperplasia Benign Tumors of the Liver

■Gross hematuria: recurrent urinary tract infection

■Bladder stones

■Upper tract obstruction and azotemia: rare

Benign Tumors of the Liver.............................

EMMET B. KEEFFE, MD

history & physical

History

■Cavernous hemangioma most common benign tumor of liver

■Other two common benign tumors of liver: focal nodular hyperplasia

& hepatic adenoma

■Most benign tumors asymptomatic & detected on abdominal imag-

ing

■Cavernous hemagiomas occur in all ages, mostly in third to fifth

decade of life; male/female ratio 4:1 to 6:1

■FNH much less common than cavernous hemangioma, but more

common than hepatocellular adenoma

■FNH usually asymptomatic, but up to 1/3 may be associated w/

abdominal pain

■FNH 2:1 female predominance

■Hepatocellular adenoma primarily in users of oral contraceptives,

w/ estimated prevalence of 1–3/100,000

■Hepatocellular adenoma has significant risk of rupture & malignant

degeneration

Signs & Symptoms

■All 3 lesions most commonly detected asymptomatically

■Widespread use of abdominal imaging often leads to detection

■Occasionally, tumors identified on routine laparotomy for other indi-

cations

tests

Basic Blood Tests

■Routine LFTs typically normal

Imaging

■Cavernous hemangioma: well-defined hyperechoic mass on US;

hypodense lesion w/ peripheral contrast enhancement followed by