Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 41: A Healthy Patient Not Known To Have Chronic Liver Disease, With Normal Liver Chemistries And Liver Function, Was Found To Have A 4-Centimeter Liver Mass On Ultrasound. Should I Biopsy This? (continued)

Douglas M. Heuman, MD; Adil Habib, MD

The answer to this simple question is unfortunately rather complicated. Biopsy plays an important role in diagnostic evaluation of liver masses, but it is not always necessary and may be harmful. The decision to biopsy, like all other decisions in medicine, requires balancing of risks and benefits.1 Compared to routine percutaneous liver biopsies performed for evaluation of liver disease, biopsies of liver masses carry a higher risk of hemorrhage. This is especially true for highly vascular tumors. Spread of malignant cells along the needle track is well documented with biopsy of…