Liver mets?

[lbada]

My wife (35 yrs.old) was diagnosed over 2 yrs ago with stage 1a (1.5 mm tumour) breast cancer and thyroid cancer in '99 and also been clinically diagnosed with Cowden's syndrome (multiple hamartoma syndrome)recently.  She is doing well.  She had an abdominal ultrasound ( 1st time, part of regular screening for Cowden's syndrome).  Radiologist found single 5mm lesion consistant with hemangioma on her liver, but could not exclude metastasis due to her history and ordered follow-up with CT.  Our question is, how do mets usually present, as single lesion or multiple?  Generally how good is ultrasound at distinguishing between the two (should we be hopeful with her impression of hemangioma)?  Is hemangioma common on the liver?  Thanks in advance.

[CCF-RN,MSN-rf]

Dear lbada:  Liver metastasis can appear as a single lesion or as multiple lesions.  Ultrasound is good at distinguishing fluid filled versus solid but may not be the best test to differentiate between hemangioma and metastasis.  Hemangiomas are not uncommon in the liver.  The CT scan will hopefully help determine what this is.

[surgeon]

hemangioma is very common on the liver, and generally is of no significance. Mets typically present as multiple. Sonogram isn't able to make a definite distinction, but given the size and singularity and apparent characteristics, it seems highly likely it's either a hemagioma or some other non-dangerous finding.