Almanac of Clinical MedicineAlmanac of Clinical Medicine2072-05052587-9294Moscow Regional Research and Clinical Institute (MONIKI)90110.18786/2072-0505-2018-46-6-618-630Diagnostic and treatment challenges in focal liver diseaseZhaoA. V.<p class="MsoNormal"><span lang="EN-US">Alexey V. Zhao – MD, PhD, Professor, Deputy Director.</span></p><p class="MsoNormal"><span lang="EN-US">27 Bol'shaya Serpukhovskaya ul., Moscow, 117997</span></p>fake@neicon.ruKarmazanovskyG. G.<p class="MsoNormal"><span lang="EN-US">Grigory G. Karmazanovsky – Member-Correspondent of Russian Academy of Sciences, MD, PhD, Professor, Head of the Radiology Department.</span></p><p class="MsoNormal"><span lang="EN-US">27 Bol'shaya Serpukhovskaya ul., Moscow, 117997</span></p>fake@neicon.ruBugaevS. A.<p class="MsoNormal"><span lang="EN-US">Sergey A. Bugaev – MD, PhD, Management Advisor.</span></p><p class="MsoNormal"><span lang="EN-US">27 Bol'shaya Serpukhovskaya ul., Moscow, 117997</span></p>fake@neicon.ruChugunovA. O.<p class="MsoNormal"><span lang="EN-US">Andrey O. Chugunov – MD, PhD, Associate Professor, Chair of General Surgery and Radiodiagnosis, Therapeutic Department.</span></p><p class="MsoNormal"><span lang="EN-US">1 Ostrovityanova ul., Moscow, 117997, tel.: +7 (926) 229 98 10</span></p>ch123@rambler.ruA.V. Vishnevsky National Medical Research Center of SurgeryPirogov Russian National Research Medical University291120184666186302811201828112018Copyright © 2018, Zhao A.V., Karmazanovsky G.G., Bugaev S.A., Chugunov A.O.2018<p>Finding a focal liver lesion during screening may not uncommonly lead to a misinterpretation of the results of radiological diagnostics. Based on the consolidation of our wide experience (more than 1000 cases) of surgical treatment of patients with various focal liver diseases, we analyzed the main causes of diagnostic pitfalls and, as a consequence, errors in the treatment of these patients. The most typical objective and subjective diagnostic pitfalls that may lead to a wrong treatment strategy are discussed with clinical cases taken as examples. The objective factors are related to the rarity of disease, absence of pathognomonic semiotics, as well as limitations in the resolution power of imaging methods. In addition, a misinterpretation of results of ultrasound examination, magnetic resonance imaging and multiaxial computed tomography may be explained by identical properties of images in different tumors related to similar physical and chemical properties of a lesion. The subjective factors are related to a wrong interpretation of clinical and instrumental assessment data, or insufficient evaluation needed in an individual patient. The number of diagnostic and treatment errors could be decreased by a multidisciplinary approach taking into account the opinions of various profile experts.</p>focal liver diseasediagnosticsdifferential diagnosticssurgical treatmentочаговые заболевания печенидиагностикадифференциальная диагностикахирургическое лечение[1. Кубышкин ВА, Чжао АВ, Вишневский ВА, Сидоров ДВ, Икрамов РЗ, Козлов ИА. Атлас операций при злокачественных опухолях печени и поджелудочной железы. М.: Практическая медицина; 2017. 160 с.][2. Вишневский ВА, Кубышкин ВА, Чжао АВ, Икрамов РЗ. Операции на печени. Руководство для хирургов. М.: Миклош; 2003. 156 с.][3. Hawkey CJ, Bosch J, Richter JE, Garcia-Tsao G, Chan FKL, editors. Textbook of clinical gastroenterology and hepatology. 2nd edition. Wiley-Blackwell; 2012. 1272 p.][4. Шевченко ТВ, Паклина ОВ, Кармазановский ГГ, Яшина НИ, Жаворонкова ОИ, Мелехина ОВ, Ветшева НН, Шуракова АБ, Чжао АВ. Псевдовоспалительная опухоль печени. Доказательная гастроэнтерология. 2013;(2): 63–9.]