Irregular and Non-Tender Hepatomegaly

CLINICAL DIAGNOSTIC MANUAL

Irregular and non-tender hepatomegaly refers to an enlargement of the liver with a nodular or irregular surface that does not cause pain upon palpation.

This sign may indicate serious pathological processes, such as neoplasms or chronic infections, that affect the liver’s structure. Identifying the underlying cause is crucial for the appropriate and timely management of the patient, as many of these conditions may require specialized treatment.

Condition	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Metastatic carcinoma	Nodular hepatomegaly, weight loss, anorexia, fatigue, jaundice, ascites, mild abdominal pain, symptoms from the primary cancer site	Medical history, clinical symptoms, history of cancer	Abdominal CT/MRI, liver biopsy, PET-CT
Hepatoma (Hepatocellular carcinoma)	Nodular hepatomegaly, weight loss, anorexia, fatigue, jaundice, ascites, gastrointestinal bleeding, right upper quadrant pain	Medical history, clinical symptoms, risk factors (hepatitis B/C, cirrhosis)	Alpha-fetoprotein (AFP), abdominal CT/MRI, liver biopsy
Hydatid cyst	Hepatomegaly, palpable liver mass, compression symptoms, fever, jaundice, anaphylaxis in cases of rupture	Medical history, contact with animals, clinical symptoms	Abdominal ultrasound, serology for hydatid disease, abdominal CT/MRI