CHU Bordeaux, Haut-Lévèque Hospital, Department of Digestive Surgery, Pessac, F-33600, France.
Semin Liver Dis. 2013 Aug;33(3):236-47. doi: 10.1055/s-0033-1351779. Epub 2013 Aug 13.
The widespread use of imaging modalities and the continuous improvement in their sensitivity have lead to an increasing number of incidental findings of focal liver masses, either solitary or multiple. Most of these so-called incidentalomas are benign and are discovered in healthy, asymptomatic patients. The main issue is to ensure the proper diagnosis, so that clear management recommendations can be provided. Surgery is rarely indicated in these circumstances. Infrequently, benign liver tumors are diagnosed because of symptoms or complications, and require urgent management including surgery as a major role in the cure. Due to better understanding of the clinical and pathological features of benign liver tumors, the increased accuracy of imaging tools, and improvement in surgical techniques (including laparoscopy), the management of these lesions has evolved. Here the clinical and biological features of the most common solid and cystic benign liver tumors are reviewed, and the key points of management focusing on the role of surgery, preventive or diagnostic, are addressed.
影像学检查手段的广泛应用和其敏感性的不断提高导致越来越多的偶然发现的局灶性肝肿块，无论是单发还是多发。这些所谓的偶然发现的病变大多数是良性的，且发生在健康、无症状的患者中。主要问题是确保正确诊断，以便提供明确的管理建议。在这些情况下，手术很少有指征。良性肝肿瘤因症状或并发症而被诊断的情况很少见，需要紧急管理，包括手术，这是治愈的主要手段。由于对良性肝肿瘤的临床和病理特征有了更好的了解，影像学检查工具的准确性提高，以及手术技术（包括腹腔镜）的改进，这些病变的管理也发生了变化。本文回顾了最常见的实性和囊性良性肝肿瘤的临床和生物学特征，并重点介绍了手术的管理要点，包括预防性或诊断性手术。
