Digestive Disorders / Gastroenterology Expert Forum
Re: Unidentified hypervascular liver lesion
About This Forum:

This is a place to ask questions about digestive problems and receive a personal answer from a highly qualified doctor. You will also find support from other members who share your interest in digestive disorders. Digestive Disorders include: Anal and Rectal problems, Barrett’s Esophagus, Bleeding in the Stomach and Digestive Tract, Constipation, Crohn’s Disease, Gastritis, GERD, Heartburn, Proctitis, Short Bowel Syndrome, Ulcers, Whipple’s Disease, Zollinger-Ellison Syndrome (and many more).

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank

Re: Unidentified hypervascular liver lesion

Posted By kd on July 13, 1999 at 09:42:34
Hi.
I am a 48 yo female.  A little over a year ago, I underwent a renal scan to try to find the cause of my systolic hypertension.  While there were no renal artery problems, they located a soft tissue mass (>3 cm) within the medial aspect of th anterior segment of the right lobe of the liver which was hypervascular as well as a smaller (1.5 cm) similar appearing nodule at the tip of the right lobe of the liver.  This was done with a CT with contrast (heterogenous internal enhancement during the arterial phase).  The impression was that "its enhancement characteristics were somewhat nonspecific, but not entirely compatible with hemangioma.  Differential considerations include both primary and secondary hypervascular hepatic neoplasm, hepatic adenoma, or focal nodular hyperplasia.
Subsequently, I underwent a RBC SPECT Scan to R/O hemanioma.  The "right lobe of the liver failed to demonstrate accumulation of red blood cells to suggest evidence of hemangiomas."
I was sent to an area teaching hospital for further investigation.  I had a cardiac MRI (for another reason) which showed the liver lesion but without sufficient definition to help identify the it.  I also had an abdominal MRI which revealed a 2.4x2.7x3 cm lesion on the infraomedial aspect of the posterior segment of the right lobe of the liver...slightly heterogeneous...predominantly decr. signal intensity on the Tx weighted images...moderately incr signal intensity on the T2 weighted images relative to liver...Following gadolinium admin., ...lesion demonstrates immediate intense and heterogenous enhancement...persists up to 10 min. after contrast admin.   Impression:...hepatic neoplasms such as focal nodular hperplasia and a hepatic adenoma or hepatocellular carcinoma.  The imaging characteristics are not diagnostic of either an adenoma or an FNH.
The docs shrugged and said it's probably hemangioma.  Go away and come back in 6 mo for a re-scan.  Too vascular for biopsy.  (Which I have no problem with - the lack of the biopsy, I mean.)
6-mo follow-up CT scan (almost a year ago) -   Saw the larger mass but not the smaller one on the tip of the right lobe.  No changes and no new lesions.  No comments were made beyond that that would help in diagnosis.
Questions:
1.  Do you have any ideas as to the identity of the lesion.  Is an identity important?
2.  Could this liver lesion contribute to the atherosclerosis obliterans that has been diagnosed in me?  My arteries are not so slowly clogging and they don't know why.
3.  I take Lipitor for borderline high cholesterol levels.  With Lipitor the readings are consistently in the low 120s.  It also seems to have lowered chronically high GGTPs ranging from 64 to 107, high Protein and Albumin levels.  
Could the Lipitor be contributing to/causing  the lesion?
4. Do you have any ideas as to what I should be doing about this?  Because I have some heart problems (3+ mitral regurg) and vascular problems (with carotid occlusion and TIAs), the focus seems to go to other areas and I'm not getting any guidance as to the importance of this liver thing (other than they don't want to operate on the other stuff because they don't know what the liver thing is).
If you can give me some information that will help me ask the right questions or give my docs a new direction, I'd be VERY appreciative.
Thanks for considering my question.
kd




Related Discussions
0 Comments
Blank
Avatar_n_tn
Posted By PS -kd on July 13, 1999 at 09:59:03
I forgot to mention, in case it is important - I do not have hepatitis C (had the shots) or cirrhosis of the liver.  I am a non-drinker and always have been.  My grandfather (who was an alcoholic) did die of cirrhosis of the liver and/or black lung disease (I've heard both.)  I do not smoke (never have) and am thin for my size (93 lbs, 5'3").
Thanks again.
kd




Blank
Avatar_n_tn
Posted By Danetta Schreiber on September 25, 1999 at 22:25:17
I am also 48 and was diagnosed with liver hemangianomas of the liver in 1982.  I have 3--- one large one on the right lobe and one large one on the left lobe and then another smaller one.
I have been trying to find out more about them because I had a hysterectomy in May and am on Premarin and when these were first diagnosed my doctor said to not take any birth control pills or hormones.  They are suppose to make them grow.
I had a CT 9-99 and they seem to be about the same. They are not able to operate because I have to many and they feel the surgery has as much risk as just leaving them alone.
Would appreciate any info anyone has on where I can get more info.  I have found that they really don't know much about these, everyone just seems to be very vague about them.
Thanks, DS










Follow Ups:






Blank
Avatar_f_tn
A related discussion, Hepatic hemangianomas ? was started.
Blank
Avatar_f_tn
I too, 53 female has been apart of this unique club for 23 yrs now. I also became a pt of specialist , esp Cleveland Clinic. I have had a one time 15 masses ranging 4cms to 1cm. The problem hypervascular mass is centered in the middle of the portal hepatis. Over the yrs , mine have change charactericts also. Very few are detected since I was prescribed  tamoxifin (tamoxifen) to decrease estrogen levels 10 yrs ago. I do have moderate to severe total right side and epigastric pain. How is the quality of life for each of you? Bless u and thank-you, Teresa
Continue discussion Blank
This Forum's Experts
351246_tn?1379685732
Dr. Kokil MathurBlank
Consultant
,
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank