Benign liver tumors

To benign liver tumors that have practical value apply vascular tumors: angioma, cavernous angiomas, cavernoma and adenomas.
Vascular tumors of the liver. There are two types of vascular tumors of the liver: 1) angioma elderly who do not reach a large size and not give almost no clinical symptoms. They can meet by chance during surgery on the stomach or biliary tract. Angiomas are often multiple; 2) congenital angiomas, which occur at any age and can reach a very large sizes.
Symptomatology. Reached a considerable size hemangioma cause patients a feeling of heaviness in the stomach, not associated with eating, sometimes weakness. Cavernoma may cause pressure on the stomach: when pressure on cardio - phenomena dysphagia, when the pressure on the porter - vomiting. Patients themselves often say in my stomach tumors. When x-rays of the stomach is celebrated tumor beyond a shadow of a stomach, shifting the stomach to the left and down. Palpation of the abdomen is determined bumpy, plotnostei consistency painless tumor originating from the left lobe of the liver or from the free edge of the right lobe of the liver. The tumor moves when you inhale and has lateral offset to the right or left, if it is on the leg. Recognition of cavernoma helped if Beck (1801) listening vascular noise, and in the case of Geman (1913) a presumptive diagnosis was put on the grounds that the tumor in case of compression decreased.
Cavernoma liver may exist a number of years without change. Sometimes there are breaks with dangerous bleeding or with the formation of cysts and malignant transformation. More rare outcomes of cavernoma applies herself, hemangioma, encapsulating or scarring. Described calcification hemangioma, diagnosed by chest x-ray (Aspray, 1945).
Cavernous angiomas reach sometimes much weight. So, in observation M. A. Kemerovskogo remote cavernous angioma entire left part of the right lobe of the liver weighed 2,8 kg In the case of Geman the tumor weighed 22 kg (C. H. Mitroshenko, 1947).
From the above it is seen that the symptoms when developed and reached a considerable size of the angioma - cavernoma - is caused by the pressure of the tumor on different parts of adjacent organs and disorders of the functions of these bodies. Since diagnosis of Kavarna liver is not based on pathognomonic symptoms, described in the literature of observations noted various diagnostic error: the tumor (cancer) of the stomach, liver echinococcosis, cyst pancreas, shifted to the right kidney, swelling of the gallbladder, spleen and other auxiliary diagnostic methods should mention the pneumoperitoneum and laparoscopy.
Treatment. As described in the literature 64 observations of Kavarna liver surgery resection of the left lobe of the liver produced in 63 cases, 20 of them produced domestic surgeons.
Adenoma of the liver. In postmortem literature there are indications of a link between adenomas, cirrhosis and liver cancer. Hepatic adenoma arise from the cells of the liver and bile ducts. Meet hepatic adenoma in the form of single or multiple tumors. Adenomatous site is restricted from liver tissue fibrous capsule, but the latter may be absent. More often adenomas bile ducts. Both can be significant (with a fist adult and children's head). In the centre adenomas may be the formation of cavities. Adenomas occur at any age. With the development in the centre of adenoma more significant cavity all the tumor becomes a spherical shape. Such tumors given the name of cystadenoma. Adenoma-cystadenoma develop slowly, and their clinical manifestation begins from the moment when they begin to cause pressure on neighboring organs, primarily on the stomach and duodenum. Described sudden onset of abdominal pain in an "acute abdomen" when you break the tumor and intraperitoneal bleeding (Warvy, 1945).
Diagnostics. Distinctive diagnostic signs adenomas a bit: it can have a spherical shape, whereas cavernoma is hilly tumor. The larger size of the tumor at an adenoma aperture is raised on the side of tumor development that is set to more accurately fluoroscopy, pneumoperitoneum or laparoscopy.
Treatment adenomas, have reached great dimensions, only online. As a rule, it is resection of part of the liver tumor or the whole of the left lobe with a significant spread of tumors in the past. However, the spherical form solitary adenomas may remove its enucleation (husking) together with the capsule surrounding the adenoma.