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Differential Diagnosis of the Liver Mass

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