Tumores Hepáticos 2014
The writing group was invited by the Practice Parameters Com- mittee and the Board of the Trustees of the American College of Gastroenterology to develop a practice guideline regarding the suggested diagnostic approaches and management of focal liver lesions (FLLs). FLLs are solid or cystic masses or areas of tissue that are identified as an abnormal part of the liver. The term “lesion” rather than “mass” was chosen because “lesion” is a term that has a wider application, including solid and cystic masses. This guideline will be limited to primary liver lesions and the management approach to FLLs rather than focusing on the diagnosis and management of metastatic lesions, hepatocellular carcinoma, or cholangiocarcinoma. For specific reading on these lesions, the reader is referred to other recent guidelines (1–3). An evidence-based approach was undertaken to critically review the available diagnostic tests and treatment options of FLLs. The following resources were utilized: (i) a formal review and analy- sis of the published literature using MEDLINE via the OVID interface up to June 2013 with the search terms “hepatic/liver mass,” “hepatic/liver tumor,” “hepatic/liver cancer,” “hepatic/liver lesion,” “hepatocellular adenoma,” “liver adenomatosis,” “hepatic hemangioma,” “focal nodular hyperplasia,” “nodular regenera- tive hyperplasia,” “hepatic cyst,” “hepatic cystadenoma,” “hepatic cystadenocarcinoma,” “polycystic liver disease,” and “hydatid cyst,” without language restriction; (ii) hand reviews of articles known to the authors; and (iii) the consensus experiences of the authors and independent reviewers regarding FLLs. The guide- line was prepared according to the policies of the American College of Gastroenterology and with the guidance of the Practice Parameters Committee. The GRADE system was used to grade the strength of recommendations and the quality of evidence (4).