Is it the Hemangiomas?

  I am a 42 year old female, do not take birth control pills. Approx. six weeks ago I started to have back pain in the upper right quandrant. It slowly radiated across the back and then was joined by the onset of acute abdominal pain in the URQ. Family Practice DR. first treated it as muscle sprain, prescribing Darvocet and Soma, a muscle relaxant. Nausea and loss of appetite followed.  An upper GI series was unremarkable. An ultrasound of area revealed a 2cm well circumscribed lesion on the liver. A further dynamic MRI confirmed the 2cm lesion in addition to two other smaller lesions which were said to be hemangiomas. Was referred to a Gastro specialist who treated the symptoms as a possible pre-ulcer condition. Was put on previcid and carafate, which gave me diahrea (sp?) and lost 5 pounds in a week. Discontinued the meds, am now taking over the counter xantac twice a day, but still have general discomfort, plus spells that just "wipe me out". I am tired, feel no energy, little appetite, despite vitamins, yoga and walking to relieve stress. Gastro specialist did more blood tests today (earlier tests 6 weeks ago were fine) and has set me up for an endoscopy procedure in a week. I'm frustrated, and wondering, could this liver hemangioma be causing my discomfort? Should a biopsy be done? I just want to feel "normal" again. Thanks.
Dear Terry,
Hemangiomas are the most common benign tumor of the liver. They occur at all ages but are most common in the third, fourth and fifth decades of life. They are more common in women. They may increase in size during pregnancy. Most are seen incidentally on various imaging studies. Although a hemangioma has a characteristic echogenic appearance on ultrasound, this appearance is not peculiar to hemangioma. When a hemangioma is detected on ultrasound it is often confirmed with a second study called dynamic hepatic blood flow scintigraphy (red blood cell scan). This scan can detect hemangiomas 3 cm or larger
with good accuracy. Other more expensive tests such as a dynamic CT scan or MRI are more accurate and can even detect smaller hemangiomas. Treatment for hemangioma is only indicated if it is large, increasing in size and displacing surrounding structures and organs, causing severe symptoms, or thrombosis or hemorrhage of the tumor is present (acute abdominal pain). It would be unlikely that your current symptoms are related to the hemangiomas detected in the liver. Because liver hemangiomas are vascular tumors (composed of blood vessels) biopsies are generally contraindicated.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.
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*Keywords: liver hemangioma