Benign hepatic tumors

Najčešći dobroćudni tumori jetre su hemangiom, fokalna nodularna hiperplazija i hepatocelularni adenom. Najčešće ih otkrivamo u mladih žena. Dobroćudni tumori jetre većinom ne uzrokuju simptome te se najčešće otkrivaju slučajno slikovnom dijagnostikom. Pacijenti koji imaju simptome najčešće se žale na nespecifičnu nelagodu u gornjem dijelu trbuha. Klinički su značajni jer ih je ponekad teško razlikovati od malignih tumora na radiološkim pretragama. Fokalna nodularna hiperplazija hamartom je građen od hepatocita. U postavljanju dijagnoze najkorisniji je MR s kontrastom. U većini slučajeva nije potrebno liječenje. Hemangiom je dobro ograničen tumor građen od kavernozno proširenih kapilara. Rijetko mogu nastati komplikacije hemangioma: spontana ili traumatska ruptura, kompresija okolnih struktura, torzija i/ili infarkt pedunkuliranog hemangioma, krvarenje i Kassalbach-Merrittov sindrom. Hemangiom je potrebno liječiti samo u slučaju razvoja komplikacija. Ultrazvuk je dovoljan za postavljanje dijagnoze kod hemangioma manjih od 3 cm s tipičnim radiološkim značajkama. Ipak, MR najbolja je slikovna tehnika u dijagnostici hemangioma s osjetljivošću od skoro 100% i specifičnošću od 85,7%. Uzimanje oralnih kontraceptiva rizični je čimbenik za razvoj hepatocelularnog adenoma. Rizik za malignu transformaciju hepatocelularnog adenoma je oko 6%. Kirurški liječimo sve muškarce s hepatocelularnim adenomom i žene s hepatocelularnim adenomom većim od 5 cm. Cilj je ovog rada dati preglednu sintezu nedavnih spoznaja o epidemiologiji, etiologiji, kliničkoj slici, dijagnostici i liječenju dobroćudnih tumora jetre.The most common benign hepatic tumors are hemangioma, focal nodular hyperplasia, and hepatocellular adenoma. They are most commonly found in young women. In the majority of cases, benign liver tumors do not cause symptoms and are most often detected accidentally by imaging. Patients who have symptoms most often complain of non-specified discomfort in the upper abdomen. They are clinically significant because sometimes they are difficult to differentiate from malignant tumors on radiological examinations. Focal nodular hyperplasia is a hamartoma made up of hepatocytes. Contrast-enhanced MR is the most useful imaging modality in making the diagnosis. In most cases, no treatment is needed. Hemangioma is a well-demarcated tumor which consists of cavernously dilated capillaries. Complications of hemangiomas are rare: spontaneous or traumatic rupture, compression of surrounding structures, torsion and/or infarction of the pedunculated hemangioma, bleeding and Kassalbach-Merritt syndrome. Hemangiomas should be treated only if complications occur. Ultrasound is sufficient to diagnose hemangiomas smaller than 3 cm with typical radiological features. Nevertheless, MR is the best imaging technique in the diagnosis of hemangiomas with a sensitivity of almost 100% and a specificity of 85.7%. Taking oral contraceptives is a risk factor for developing a hepatocellular adenoma. The risk of malignant transformation of hepatocellular adenoma is about 6%. All men with hepatocellular adenoma and women with hepatocellular adenoma larger than 5 cm are treated surgically. This paper is a systemic review of the recent findings in epidemiology, etiology, clinical presentation, diagnosis and management of benign liver tumors