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Causes of Spots on the Liver

by
author image Dr. Tina M. St. John
Tina M. St. John runs a health communications and consulting firm. She is also an author and editor, and was formerly a senior medical officer with the U.S. Centers for Disease Control and Prevention. St. John holds an M.D. from Emory University School of Medicine.
Causes of Spots on the Liver
Single or multiple spots can appear in the liver. Photo Credit 7activestudio/iStock/Getty Images

Overview

Imaging studies of the liver, including ultrasound, CT and MRI scans, allow doctors to visualize the structure and texture of the organ. Liver tissue normally has a uniform appearance on imaging scans. A spot on the liver -- also known as a hepatic mass -- describes a solid area that appears different from the majority of the liver tissue. Infections, inflammatory reactions and various types of noncancerous and cancerous tumors can appear as spots on the liver. Additional tests help identify the underlying cause of a spot seen on a liver imaging study.

Hepatic Hemangioma

A hemangioma is a noncancerous tumor composed of abnormal blood vessels that form during development in the womb. Hepatic hemangiomas are the most common type of noncancerous liver tumor. These tumors occur more commonly in females than males and may present at any age, although most come to light during adulthood. Most hemangiomas are small, do not cause symptoms or interfere with liver function, and are discovered incidentally. Large hemangiomas might cause pain in the right upper abdomen, and possibly nausea, vomiting and early fullness with meals. Rarely, blood vessels within a hemangioma rupture, necessitating treatment to stop the bleeding.

Focal Nodular Hyperplasia

Focal nodular hyperplasia (FNH) is the second most common type of noncancerous liver tumor. It occurs due to localized overgrowth of liver cells, or hepatocytes, and associated blood vessels in an otherwise healthy liver. As with liver hemangiomas, these tumors affect women more commonly than men, generally cause no symptoms, and usually come to medical attention coincidentally. In up to 20 percent of cases, two or more of these tumors are present in the liver. FNH does not impair liver function and typically requires no treatment. Removal is sometimes recommended for large tumors, although this is rare.

Hepatic Adenoma

A hepatic adenoma is a relatively uncommon, noncancerous liver tumor. These growths most often occur in women of childbearing age, and those who take oral contraceptives are most frequently affected. Liver adenomas, also known as hepatocellular adenomas, arise from the abnormal growth of liver cells. In rare cases, multiple liver adenomas develop in association with an inherited abnormality known as familial liver adenomatosis. Among women taking oral contraceptives, discontinuation of use generally leads to shrinkage or disappearance of the tumor. Liver adenomas usually cause no symptoms, but can cause sudden abdominal pain if bleeding occurs within the tumor. Large liver adenomas may require surgical removal.

Hepatic Granuloma

Hepatic granulomas represent distinct masses of inflammatory tissue that appear as spots on liver images. These uncommon, noncancerous masses sometimes form in response to infections that involve the liver, such as tuberculosis, schistosomiasis, cat scratch fever, syphilis, histoplasmosis, toxoplasmosis, tularemia and cryptococcosis. Other conditions that might provoke the development of liver granulomas include sarcoidosis, Hodgkin lymphoma and polymyalgia rheumatica, an autoimmune disorder. Most liver granulomas do not cause liver-related symptoms. Treatment usually focuses on addressing the underlying condition responsible for the liver granulomas.

Liver Cancer

Liver cancer is the most serious and potentially life-threatening cause of spots on a liver scan. The American Cancer Society estimates the occurrence of more than 40,700 new cases of liver cancer among Americans in 2017, with roughly 70 percent occurring in men. While many other types of cancer are decreasing in the United States, rates of liver cancer have increased by approximately 3 percent annually from 2000 to 2017. Chronic hepatitis C is the leading cause of liver cancer among Americans. Other risk factors include chronic hepatitis B, noninfectious liver cirrhosis, alcohol abuse and iron overload. Liver cancer usually does not cause symptoms until the disease reaches an advanced stage. Regular ultrasound monitoring of the liver among people at high risk for liver cancer can help detect early-stage disease.

Metastatic Liver Cancer

Certain types of cancer commonly spread to the liver, including lung, breast, colon and pancreatic cancers. The term metastatic liver cancer, or liver mets, describes liver tumors arising from the spread of cancer from another location in the body. Metastatic liver cancer is more common than cancer arising from the liver itself. Metastatic liver cancer is frequently considered an ominous development because cancer that spreads from one organ to another often cannot be cured.

Other Considerations

A hepatic cyst refers to a hollow or fluid-filled growth in the liver. Medical professionals typically don't refer to cysts as liver spots or masses since they aren't solid growths. Nonetheless, you might want to inquire about the possibility of a liver cyst if your doctor informs you that something was seen on your liver imaging study. There are many types of liver cysts and most are noncancerous. People with large or multiple cysts may experience symptoms or disruptions in liver function. Treatment depends on the type hepatic cyst, and the size and number of these growths in the liver.

Although it is understandably alarming, try not to panic if you're informed that a spot has been discovered in your liver. Work with your doctor to determine the nature of the growth, keeping in mind that most liver masses are not cancerous and do not pose a serious threat to your liver or overall health.

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