[Diagnosis and surgical therapy of benign liver tumors]

Between 1/1980 and 12/1992 at the Surgical Clinic (Charité) 251 patients were treated for benign liver tumors. In 139 cases a laparotomy was necessary. Fourty of these operations were explorative laparotomies only, whereas among the resections there were mainly atypical and segmental resections, respectively (n = 81). In the case of focal nodular hyperplasia (FNH) and hemangioma the indication for operation resulted from the patients' complaints (n = 45) and the preoperatively uncertain dignity of the process (n = 50). If an adenoma was suspected (n = 38) an absolute indication for operation was assumed with respect to the danger of rupture or bleeding reported in the literature as well as the uncertain differentiation from malignancy often experienced. The suspected diagnosis was proved in 30 cases, in 8 patients a FNH was found intraoperatively without the consequence of resection. Six patients were resected for a suspected hepatocellular carcinoma (HCC) which could not be confirmed postoperatively. In conclusion, the rate of preoperative uncertain or wrong diagnoses concerning definitive histology was 25.4%. The mortality rate of the performed liver resections was 2%, but was not directly related to the liver resection per se. In 4 patients the postoperative course required a relaparotomy. By a follow-up starting with 3-months intervals, two patients with an hepatocellular carcinoma were detected 12 weeks after the first diagnosis of FNH. A successful resection was carried out in both cases.