Liver mass medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

The majority of cases of liver masses (benign liver tumors) are asymptomatic and require only supportive care. Medical therapy is indicated only in cases of cystic lesions. Surgery is the main stay of treatment for solid lesions.

The majority of cases of liver masses (benign liver tumors) are asymptomatic and require only supportive care. Medical therapy is indicated only in cases of cystic lesions. Surgery is the mainstay of treatment for solid lesions.

• Hepatic abscess
  • Empiric antibiotic therapy based on culture and sensitivity include:^[1][2]
    • 1.Monotherapy
      • Preferred regimen(1):Ampicillin–sulbactam 3 g IV every six hours
      • Preferred regimen(2):Piperacillin–tazobactam 3.375 or 4.5 g IV every six hours
      • Preferred regimen(3):Ticarcillin–clavulanate 3.1 g IV every four hours
    • 2.Combination therapy
      • Preferred regimen(1):Ceftriaxone 1 g IV every 24 hours or 2 g IV every 12 hours for CNS infection plus Metronidazole 500 mg IV every eight hours

• Hepatic echinococcosis
  • Management depends upon the cystic grading
    • There are 3 options for the treatment of cystic echinococcosis: anti-infective drug treatment, percutaneous treatment of the hydatid cysts with the PAIR (Puncture, Aspiration, Injection, Re-aspiration) technique and surgery.
      • Preferred regimen: Albendazole 10 to 15 mg/kg per day q12
      • Alternative regimen: Puncture, aspiration, injection, re-aspiration (PAIR)