The liver is one of the most vital organs in the body—no less important than the brain or the heart. As the largest internal organ, it stores nutrients and glucose, supports cellular growth, helps eliminate bacteria and toxins, and metabolizes medications to make them effective in targeted organs. Any abnormality in the liver can lead to serious health conditions, making it essential to monitor for signs of dysfunction—such as the development of liver masses.
Liver Masses: Causes and Symptoms
Liver masses are generally categorized into two groups:
- Benign tumors – non-invasive and non-spreading.
- Malignant tumors – classified as liver cancer.
The exact cause of these masses is often unclear. In some cases, hormonal factors such as prolonged use of oral contraceptives may be involved. Malignant tumors (cancers) may also arise without a definitive known cause. In Thailand, several risk factors have been identified, including chronic alcohol consumption, underlying hepatitis B or C infections, ingestion of foods containing carcinogens, and recurrent parasitic infections that chronically inflame the bile ducts, potentially leading to cancerous cell transformation.
In the early stages, most benign tumors do not present symptoms. As they grow, however, patients may feel abdominal discomfort or, in some cases, develop jaundice if the tumor compresses the bile ducts.
Symptoms of Liver Cancer
Liver cancer symptoms vary depending on the underlying cause:
- Alcohol-related liver cancer, often developing from cirrhosis, usually presents with a palpable abdominal mass or discomfort from a large tumor. It may also be incidentally discovered during a routine check-up.
- Cancer linked to dietary carcinogens tends to manifest non-specific early symptoms, such as loss of appetite and unexplained weight loss.
In some cases, the mass may grow significantly in size without being cancerous, such as a large hemangioma (a benign blood vessel tumor). However, these may still compress nearby organs such as the stomach or bile ducts, leading to breathing difficulties or discomfort when eating or lying down.
Risk Factors for Liver Cancer
- Chronic hepatitis B or C infections: Carriers are at significantly higher risk.
- Cirrhosis: Most liver cancer patients also present with cirrhosis.
- Aflatoxin exposure: Found in contaminated dried peanuts, chili, and fermented tofu.
- Nitrosamine exposure: Present in preservatives, salted foods, and some pesticide-contaminated produce.
- Alcohol consumption and smoking
- Underlying conditions: Diabetes, obesity, high cholesterol, and fatty liver disease
How to Prevent Liver Cancer
- Undergo annual health check-ups, including liver cancer screening, especially if you have risk factors.
- Avoid known carcinogenic substances and get vaccinated against hepatitis B.
- Maintain a healthy lifestyle to support overall liver function.
When and How to Start Screening
Liver cancer may begin developing in middle age, although younger individuals with hepatitis infections from childhood may also be affected. Benign liver tumors, by contrast, can occur at any age.
Screening is divided into two main approaches:
- For those with symptoms (e.g., abdominal discomfort or bloating): Basic screening includes abdominal ultrasound and liver function tests, which provide a good preliminary assessment.
- For asymptomatic individuals: Evaluate your risk factors—do you consume alcohol frequently? Do you have hepatitis or risk of fatty liver (e.g., diabetes, obesity)? If so, screening via comprehensive upper abdominal ultrasound or targeted liver ultrasound is recommended. Individuals with hepatitis should ideally undergo ultrasound screening every 6 months, even if they feel well.
Treatment of Liver Masses
Once a liver mass is detected, CT scans can help determine whether it is benign or malignant.
- Benign tumors: The physician will assess whether there is any potential for malignancy. In such cases, surgical removal may be recommended. If surgery is not indicated, regular monitoring will be scheduled.
- Malignant tumors: Further evaluation will be conducted to determine surgical eligibility. Biopsies may be performed, although in some cases—especially when imaging strongly suggests cancer—surgery may be recommended without biopsy to prevent potential tumor spread within the abdominal cavity.
Not all liver masses are cancerous, but timely detection is critical. Individuals with risk factors or vague symptoms should not wait for serious signs to appear. Regular screening and early diagnosis offer the best chance for successful treatment and a favorable outcome.
