[Differential diagnosis and therapy of benign liver tumors]

Hemangioma, focal nodular hyperplasia (FNH) and hepatocellular adenoma represent the most common and clinically relevant benign liver tumors. Improved diagnostic imaging procedures as well as the broad use of oral contraceptives resulted in an increased detection rate during the past 25 years. Focal liver diseases are primarily diagnosed by ultrasonography, while a specific diagnosis can be established by contrast enhanced magnetic resonance imaging. Hepatocellular adenomas should be resected, since they bear the potential of a malignant transformation as well as the risk of rupture and intraperitoneal hemorrhage. Conversely, a conservative approach is advocated for hemangioma and FNH. However, surgical procedures may be justified when a mass becomes symptomatic, and should be applied liberally when the diagnosis remains uncertain.