Which is the most common benign liver tumor?

• A. Focal nodular hyperplasia
• B. Cavernous hemangioma
• C. Hepatic adenoma
• D. Simple cyst

Answer: (B)

Cavernous hemangioma is the most common benign liver tumor. It’s a vascular malformation made up of dilated, blood-filled spaces lined by endothelium. Most are asymptomatic and found incidentally, which is why this lesion dominates the landscape of benign liver tumors compared with focal nodular hyperplasia or hepatic adenoma, and unlike simple cysts, which aren’t tumors.

On imaging, these lesions have distinctive features: ultrasound often shows a well-defined, frequently hyperechoic mass; CT or MRI typically reveal peripheral nodular enhancement in the arterial phase with progressive centripetal fill-in on delayed phases, and they usually appear very bright on T2-weighted MRI. These patterns help confirm the diagnosis without intervention.

Treatment is rarely needed unless the lesion is very large or causes symptoms. This combination of being the most common benign tumor and having characteristic imaging features explains why it’s the correct answer.