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Liver and Pancreas Benign Lesions

Liver Adenoma

Also called Hepatic (liver) Adenoma is a benign growth of the liver. It is more common in females of reproductive age, if you’re taking birth control pills containing Estrogen (a sex hormone that in females is produced by the ovaries), if you are obese or if you have certain rare genetic diseases.

Symptoms

It doesn't usually present with any symptoms, but is more likely to be found on an imaging study that you had for a different reason. Sometimes, when the liver adenoma is large enough it may cause pain. It can also sometimes rupture and cause bleeding and then you will experience signs and symptoms associated with bleeding, such as, feeling lightheaded, faint, low blood pressure, increased heart rate.

Diagnosis

If found on an ultrasound your doctor may recommend an MRI or CT to confirm the diagnosis. Biopsy is usually not necessary.

Management

  • If a liver adenoma is found in a male it is recommended to remove it by surgery because in males it has a higher risk of becoming cancer.
  • All patients who are found to have a liver adenoma are recommended to stop medications that contain Estrogen (such as birth control pills or hormonal replacement therapy) and to maintain a healthy weight (BMI<25).
  • We may recommend to remove your liver adenoma to prevent rupture and bleeding based on your age, plan to become pregnant and the size of your liver adenoma. Other times we may recommend to observe the lesion with repeat imaging in 6-12 months. Females who are already pregnant at the time of diagnosis will require closer monitoring every 6-12 weeks.

Prognosis

Liver adenoma tend to become smaller or stop growing once a person is no longer exposed to high levels of Estrogen, such as when a female reaches menopause.

Liver cyst

A liver cyst is a mass filled with fluid in your liver. The are many types but the most common is the simple cyst which is benign (not cancer). Your doctor can distinguish between the types of liver cysts based on the imaging.

A liver cyst can sometimes cause pain due to stretching of the capsule that surrounds the liver. Other times it may cause shortness of breath when it grows to a size that may prevent the diaphragm (breathing muscle) from pushing the liver down during inhalation and allowing the lung to expand. Usually, however, it does not cause any symptoms.

We recommend to remove a simple liver cyst when it causes the patient pain, discomfort or shortness of breath. The procedure is done laparoscopically, using small skin incisions and a camera, and can be done as a same day procedure – arrive for surgery in the morning and be discharged to home in the afternoon. During the surgery we open the cyst, drain it and remove part of it so it doesn't come back.

Pancreas cyst

Cysts are fluid filled growths. They are very commonly found in the pancreas usually when performing imaging studies for other reasons. A cyst in the pancreas can be completely benign (with no potential to become cancer), pre-malignant, which means it may harbor cancer or grow into cancer in the future, or it can already be cancer.

Usually, you would not have any symptoms or signs due to a cyst in the pancreas. When a cyst is found more imaging studies may need to be done to evaluate whether the cyst has a potential to be cancer or not. This will guide us to whether the cyst fluid should be sampled for fluid or whether the cyst should be removed with an operation (surgery). Sometimes, it is recommended to observe the cyst by repeating imaging studies in 6-12 months and checking to see if the cyst grew in size.

The type of operation to remove a cyst from your pancreas depends on the location of the cyst in your pancreas. If it is in the body or tail of the pancreas it can often be done laparoscopically, through small incisions that are used to introduce a camera and thin-long instruments into your abdominal cavity to complete the surgery.