[Treatment of benign tumors of the liver]

Benign hepatic tumors have today acquired an importance they did not have a few years ago. On the one hand, new X-ray techniques detect lesions unrecognized in the past, while on the other oral contraceptives increase the incidence of some and the clinical symptoms of others. Hemangioma, which is common and asymptomatic when small, may produce clinical symptoms or even severe complications when they become larger. The significant technical progress achieved in partial hepatic resection appears to allow even larger prophylactic hepatectomy. Adenoma may rupture and cause death due to intraperitoneal bleeding. In contrast to what has been claimed, interruption of oral contraceptives does not remove this risk. The following three circumstances require surgery for most large tumors: hemorrhagic risk, presence of malignant tumors (transformation? coincidence?) and impossibility and danger of attempting diagnosis by percutaneous puncture. In contrast, focal nodular hyperplasia seldom bleeds and involves no risk of malignancy, and thus surgery can be dispensed with except in the case of voluminous or compressive tumors. Solitary or multiple hepatic cysts call for surgery only when their volume discomfort. Percutaneous puncture with aspiration will gain time and allow cytologic investigation of the drained fluid. In our experience of over 140 hepatectomies in Geneva, only 22 were performed for benign tumors. Overall mortality in this survey was 11%, but there were no deaths among the 55 hepatectomies for benign lesions (including the 22 cases mentioned above).(ABSTRACT TRUNCATED AT 250 WORDS)