When medical imaging, such as an ultrasound, CT scan, or MRI, reveals “spots” on the liver, these are focal liver lesions or areas of concern. They are often discovered incidentally during scans for unrelated health issues. While the discovery of liver spots can understandably cause worry, many are benign and harmless, although some can indicate serious underlying conditions. Further investigation is needed to determine their specific cause and appropriate management.
Non-Cancerous Liver Spots
Many liver spots are benign and do not pose a serious health risk, often requiring no active treatment. Hepatic hemangiomas are a common example, representing benign tangles of blood vessels. They are often found incidentally during imaging and remain asymptomatic, particularly when small. For larger hemangiomas, or those causing symptoms like pain or fullness, various treatments exist, including surgical removal, arterial embolization to cut off blood supply, or even radiofrequency ablation.
Liver cysts are another non-cancerous spot, appearing as fluid-filled sacs within the liver. Often present from birth, they usually do not cause symptoms unless very large. Simple cysts identified on ultrasound are considered benign and do not require further evaluation.
Focal nodular hyperplasia (FNH) is a benign, tumor-like growth composed of normal liver cells, bile ducts, and blood vessels. More common in women, FNH is asymptomatic and often does not require surgical intervention. Rare fatty tumors, hepatic lipomas, also fall into the benign category of liver spots.
Cancerous Liver Spots
Liver spots can indicate malignant conditions, requiring prompt diagnosis and treatment. Primary liver cancer originates within the liver itself. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, frequently associated with chronic liver diseases such as hepatitis B or C, and cirrhosis.
Cholangiocarcinoma is another primary liver cancer that develops in the bile ducts. It is the second leading cause of primary liver cancer, diagnosed in individuals aged 60-70.
Metastatic liver cancer occurs when cancer cells from another part of the body spread to the liver. The liver is a common site for spread, with cancers from the colon, breast, and lung being frequent sources. These are secondary cancers, originating elsewhere in the body, and their presence in the liver signifies advanced disease.
Other Causes of Liver Spots
Beyond benign and cancerous growths, other conditions can manifest as liver spots on imaging. Liver abscesses are collections of pus, caused by bacterial or parasitic infections. They appear as “spots” on scans and present with symptoms like fever and abdominal pain.
Granulomas are small clusters of immune cells that form to wall off infection or inflammation. These can arise from conditions such as tuberculosis, sarcoidosis, or certain fungal infections and may be visible as small lesions on liver imaging.
Focal fatty sparing or infiltration refers to areas where fat is unevenly distributed within the liver. In a fatty liver, some areas might be “spared” from fat accumulation, appearing as distinct spots. Conversely, focal fatty infiltration involves localized areas of fat within an otherwise normal liver, which can also be mistaken for other lesions on imaging.
What Happens After Discovery
Following the discovery of a liver spot, a healthcare professional will recommend further evaluation. Diagnostic imaging plays a central role, with follow-up ultrasounds, CT scans, or MRIs used to better characterize the lesion. Different imaging characteristics help differentiate between benign, cancerous, and other types of spots.
Blood tests provide additional information, including liver function tests and tumor markers like alpha-fetoprotein (AFP), which can be elevated in certain liver cancers. While imaging is primary, these tests can offer supporting clues.
A liver biopsy, taking a small tissue sample for microscopic examination, may be necessary for a definitive diagnosis, especially if malignancy is suspected or imaging results are inconclusive. Consult a healthcare professional for proper evaluation, diagnosis, and a personalized management plan, which can range from watchful waiting to specific treatments.