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Hepatic dystychoma: a five year experience.

J M Little1, A Richardson, N Tait

  • 1Department of Surgery, Westmead Hospital, NSW, Australia.

HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery
|January 1, 1991
PubMed
Summary
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Undiagnosed solid hepatic lesions, termed dystychomas, require thorough investigation. While many are benign, malignant tumors can occur, necessitating careful evaluation despite imaging advancements.

Area of Science:

  • Hepatology
  • Diagnostic Imaging
  • Oncology

Background:

  • Incidental solid hepatic lesions are frequently discovered during routine organ imaging in asymptomatic patients.
  • These lesions, termed 'dystychomas,' present a diagnostic challenge.
  • A significant proportion of these lesions are non-neoplastic, but a concerning percentage are malignant.

Purpose of the Study:

  • To evaluate the diagnostic yield and clinical impact of a two-phase investigation program for incidentally discovered solid hepatic lesions.
  • To identify factors associated with malignancy in hepatic lesions.
  • To assess the benefit derived from organ imaging in managing these incidental findings.

Main Methods:

  • Retrospective analysis of 64 patients with solid hepatic lesions over 5 years.

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  • Implementation of a two-phase investigation program for diagnosis.
  • Correlation of clinical, biochemical, and imaging findings with lesion type (benign vs. malignant).

    • Main Results:

    • Approximately 50% of patients received a diagnosis without hospital admission.
    • Non-neoplastic lesions (73%) and hemangiomas (50%) were most common.
    • Malignant neoplasms were found in 17% of patients, with risk factors including age >55, enlarged liver, palpable mass, and elevated alkaline phosphatase.

    Conclusions:

    • Pursuing diagnosis for all solid hepatic lesions is crucial due to the risk of malignancy.
    • No single clinical, biochemical, or imaging feature reliably distinguishes benign from malignant lesions.
    • Organ imaging should complement, not replace, traditional patient evaluation methods.