Many people find “occupying lesions” in the liver during health checkups or ultrasound examinations for various diseases, and patients or family members may be surprised or afraid of this diagnosis, thinking that liver occupying lesions are liver cancer. In fact, in most cases, liver occupations are benign masses that do not require surgery or even any treatment. The most common liver mass is hepatic hemangioma, which has a high incidence, accounting for about 7% of the natural population, with a higher incidence in middle-aged people. Hemangiomas grow slowly and often have a disease duration of several years or more. When the tumor is small, it is asymptomatic. When it increases, it mainly manifests as hepatomegaly or compression of adjacent organs such as stomach and duodenum, causing symptoms such as upper abdominal discomfort, bloating, belching and abdominal pain. Most hepatic hemangiomas can be diagnosed by ultrasound, CT, MRI or nuclear scan. Those with small tumors only need regular ultrasound examinations and do not need any treatment. Although hemangiomas can cause hemorrhage if they rupture, the likelihood of spontaneous rupture and bleeding from a hepatic hemangioma is extremely small. Larger tumors with symptoms of compression should be surgically removed. Adenomas of the liver are also benign tumors of the liver and are less common than hemangiomas. They are most often seen in women and are associated with long-term oral estrogen (female birth control pills). Larger adenomas are prone to spontaneous rupture and bleeding and should be surgically removed. Other benign masses include hepatic fibronodular hyperplasia, hepatic sclerosis with large nodules, lipomas, and tuberculosis. Of course, after the initial examination reveals a liver occupancy, liver malignancy must be ruled out by necessary further tests. A common liver malignancy is primary hepatocellular carcinoma. It is mostly seen in men, with onset in middle age or above, often accompanied by chronic hepatitis or cirrhosis, and is detected by ultrasound, CT
Most of the diagnosis can be confirmed by ultrasound, CT and AFP examination, and sometimes liver aspiration biopsy is required to confirm the diagnosis. The treatment of primary liver cancer lies in early detection. Surgical resection of the tumor at the early stage is the first choice and has the best results. Other effective treatment options are: hepatic artery embolization chemotherapy via femoral artery cannulation, ultrasound-guided anhydrous alcohol injection or microwave and radiofrequency therapy, and oral medication is less effective. Since the liver is the largest substantial organ in the body, it is rich in blood flow. Cancers from other parts of the body, especially abdominal organs, may metastasize to the liver. Therefore, if liver occupancy is found and suggests malignancy, we should consider whether it is metastasis from other parts of the body. After the diagnosis is confirmed, treatment should be targeted accordingly.