Emergency hepatic arteriography with embolization should be considered to control bleeding in high-risk surgical candidates. Due to the increased risk of spontaneous, life-threatening hemorrhage and the possible malignant transformation associated with larger size tumors or in patients with glycogen storage disease, elective surgical resection is considered for all lesions greater than 5 cm in diameter. Elective resection should be undertaken only after a reasonable period of observation if OCPs have only recently been discontinued. All patients with significant elevated AFP levels should undergo resection of the tumor regardless of size. The majority can be resected locally or with segmental partial lobectomy.
Mortality is rare.
Complication rates associated with emergency surgery are higher. Laparoscopic resection can be used in patients who have small tumors within the anterolateral liver segments. A similar approach can also be considered for pedunculated lesions. Given the broad differential diagnosis, close cooperation with consulting radiologists, surgeons and pathologists is recommended. Benign hepatocellular tumors.