Focal liver lesions. Evaluation of solid neoplasms

A logical, stepwise approach to the diagnostic evaluation of solid focal liver lesions relies heavily on the fundamental clinical tools of history taking, physical examination, and identification of basic tumor markers. Imaging procedures alone or along with percutaneous, laparoscopic, or open biopsy techniques are then applied in order to obtain a specific diagnosis. The astute clinician must be concerned not only with an accurate diagnosis but also with therapeutic implications of the diagnosis balanced against the costs in terms of potential complications, survival time, resources, and patient inconvenience. A thorough understanding of the biologic behavior and natural history of the lesion helps assure a rational, cost-effective treatment strategy.