In some cases, liver damage is a sign of other problems. For example, they can indicate liver cancer or certain non-cancerous conditions, such as polycystic kidney disease.
This article explores liver damage, including what it can mean and how doctors find and diagnose it.
Liver damage includes various types of growths and tumors that develop in the liver. Most people experience no symptoms and are therefore unaware of their presence.
This is true even for cancerous lesions. Symptoms usually don’t develop until the cancer has advanced.
Liver lesions can be focal, which means they appear as an isolated growth in one area of the liver. They can also be diffuse and spread through the liver.
What are the types of liver damage?
The main way to classify liver damage is their cancerous status. They are either benign (non-cancerous) or malignant (cancerous).
Benign or non-cancerous types
In most cases, liver damage turns out to be mild. Many benign lesions do not require treatment. However, this is not always the case.
Types of benign liver injury include:
- Fibroid: These are fibrous tumors of the liver. They are relatively rare.
- Focal nodular hyperplasia: It is a lesion with a central scar. This lesion most often affects women. It usually causes no symptoms and does not require treatment.
- Granulomas: These are collections of inflammatory cells. They usually do not cause symptoms. However, their presence may indicate an underlying condition that requires treatment.
- Lipomas: These are tumors made up of fat. They usually do not cause symptoms. Like fibroids, they are rare.
- Liver abscess: This is a pus-filled growth. It requires treatment.
- Hepatic adenoma: These tumors can look like liver cancer. For this reason, it is important to get an accurate diagnosis. They most often affect young women who use hormonal birth control. It is possible but rare for these tumors to become malignant. Treatment may or may not be necessary.
- Hepatic cysts: These are very common and mainly affect women. They can present as a single cyst or as many. Treatment is rarely needed, but some types do require treatment, such as hydatid cysts. These come from the parasitic tapeworm Echinococcus granulosus.
- Hepatic hemangiomas: They are vascular tumors. They are the most common type of benign liver injury. They occur mostly in women, usually cause no symptoms, and rarely require treatment.
There are also reports of fungal infections presenting as tumor-like lesions in the liver. This further highlights the need for proper assessment.
Malignant or cancerous types
Cancerous liver damage is less common but more serious. These can be primary or secondary cancers. Primary cancers start in the liver, while secondary liver cancers start elsewhere in the body and spread to the liver.
Types of malignant lesions include:
- Angiosarcoma and hemangiosarcoma: These are types of cancer that start in the lining of blood vessels. This primary form of liver cancer is rare.
- Hepatoblastoma: It is a very rare primary liver cancer that affects children.
- Hepatocellular carcinoma: It is the most common form of primary liver cancer. It can present as a single tumor or as several smaller tumors throughout the liver.
- Intrahepatic cholangiocarcinoma: This represents up to 20% of primary liver cancers. It begins in the lining of the small bile ducts.
- Metastatic liver cancer: It’s a secondary cancer. It can spread from sites such as the breast, colon, or lungs. Secondary liver cancer is more common than primary forms in the United States.
How do doctors find and diagnose liver damage?
Doctors often discover liver damage incidentally. A common scenario is someone having an imaging test for another medical reason.
In most cases, doctors can classify lesions using lab tests and imaging tests. In a few cases, a biopsy will be needed to properly diagnose the lesion. A biopsy removes a sample of liver tissue for microscopic examination.
Imaging tests to diagnose liver damage include:
- Angiography: This visualizes the inside of blood vessels and can also deliver chemotherapy to tumors.
- CT scan: This makes it possible to obtain cross-sectional images of the liver using radiation.
- MRI: It also takes cross sections, but it uses magnets instead of radiation.
- Nuclear medicine scans: These include PET scanners and single photon emission tomography scanners, which use radioactive substances.
- Ultrasound: This uses sound waves to produce images.
Blood tests that can help diagnose liver damage and liver cancer include:
- blood chemistry panels
- blood clotting tests
- complete blood count
- kidney function tests
- Liver function tests
- tumor marker tests for liver cancer
- viral hepatitis screening
What causes liver damage?
There are various causes of liver damage. However, many liver injuries have no identifiable cause.
Some potential causes of liver damage include:
- infections, including bacterial, fungal, parasitic, and viral infections
- inflammatory conditions, such as sarcoidosis
- medications, such as allopurinol and sulfa drugs
- oral contraception
- viral hepatitis
Factors that may be linked to cancerous liver damage include:
What are the symptoms of liver damage?
Most liver damage is asymptomatic. Often people don’t realize they have liver damage because of this lack of symptoms.
If liver damage becomes extensive, it may cause discomfort, fullness, or pain in the upper abdomen. Doctors may also be able to feel for an enlarged liver.
Other possible signs and symptoms include:
- loss of appetite
- bleeding or blood clot problems
- abdominal bloating or distension
- changes in bowel habits
- dark urine
- feeling full too soon
- menstrual cycle changes
- unexplained weight gain or loss
- yellowing of the skin or eyes
How do doctors treat liver damage?
Treatment options for liver damage depend on the type and cause. Many benign lesions do not require treatment.
When symptoms appear or there is a risk of bleeding, a doctor may recommend treatment. Surgery is a common approach for benign lesions that cause problems.
Treatment for liver cancer depends on the stage of the cancer. For early cancers, surgery or transplantation may be options.
Other approaches include:
- Ablation: This destroys liver tumors without removing them using ethanol or radio, microwave or cold energy.
- Chemotherapy: This can be systemic or local with an infusion into a hepatic artery.
- Embolization: This involves injecting a substance into an artery in the liver to block blood flow to the tumour.
- Immunotherapy: This uses drugs that help a person’s immune system fight cancer.
- Radiotherapy: This delivers a dose of radiation to help destroy cancer cells and shrink tumors.
- Targeted therapy: This uses drugs that target changes in liver cancer cells.
Is it possible to prevent liver damage?
In general, liver damage is not preventable. This includes liver cancer. However, there are some things you can do to keep your liver healthy.
For example, you can try:
- avoiding hepatitis infections, for example by receiving all recommended hepatitis vaccines and being screened regularly
- have a healthy and balanced diet
- limit alcohol consumption
- maintain a moderate body weight
- avoid smoking
- treat all liver diseases
Most liver damage is benign, meaning it is not cancerous. Most people don’t know they have liver damage because it doesn’t cause any symptoms. It is common to find out that you have liver damage during an imaging test that you are having for another reason.
In many cases, these accidental lesions do not require treatment. However, getting a proper diagnosis is essential. Sometimes liver damage turns out to be cancerous or has the potential to become cancerous. These lesions require monitoring and treatment.