Liver CT Scan

I'm hoping you can help me...My mother recently went to the doctor for an 'ache' in her upper right abdomen area. There has been a large lump (the size of a palm of a hand) there since mid June 2007.

She was getting diarrhea after spicy or rich foods but once she went to a bland diet, she was OK.  She had blood work done and a CT Scan a couple of weeks ago.  

The person who did the CT Scan said her blood work looked fine (they took one vial).  The CT Scan came back with 2 masses on her liver and one on her stomach. Her primary care physician was on vacation so an 'on-call' doctor called with the CT results and told her it was cancer and that they needed to do a biopsy.

I thought it was premature to tell her this since there has been no biopsy done yet.  I didn't think a CT scan could show if a mass was benign or malignant. She has not been tired, nor sick and has not been losing weight.  She's 71 years old and quite active; doesn't smoke, doesn't eat fast-food or lots of fatty foods and is a happy person. There is no history of cancer in the family and both her parents lived to be nearly 90 years old.

She is now set for a CT Biopsy and we're all very nervous.  What are other issues we could be looking at? I have heard that benign tumors are very common in these areas.  Wouldn't her blood work have shown high enzyme levels if there was cancer in the liver? Any help you could give to me would be much appreciated. She is a nervous wreck since talking to the on-call doctor who was so quick to say it was cancer. I am really concerned about her.
Thank you.

[Kevin Pho, MD]

Difficult to comment on without looking at the CT scan.  You are right in that a biopsy is needed to conclusively diagnose cancer.  However, imaging findings can be suggestive and may increase suspicion depending on how confident the radiologist is.  

Cancer needs to be ruled out first.  Other possible causes can include more benign cysts.  

I agree with the approach - biopsy needs to be done.  Enzyme levels are not necessarily helpful in cases of liver cancer.  

These options should be discussed with her personal physician, as well as in conjunction with a GI physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[fando]

Thank you, Dr. Pho.  I guess I just would have expected the doctor who phoned my mother to not have been so grim with the prognosis with just a scan result and no 'best case scenario' comment at all.

Now she isn't eating or sleeping because she is a nervous wreck with his phone call.  She was doing fine before he called and it seems that they would want her to remain healthy; not scare her to death.

We will find out more after her CT Biopsy on the 18th. My worry about that was that if it happened to be a hemotoma or blood clot type of mass, the needle biopsy would be more dangerous to do than say, an ultrasound due to bleeding.

[suety]

A related discussion, history of melanoma stage 3 five years now diagnosed with liver lesions was started.