liver adenomas

Hello, This is a followup of a couple of questions I have had regarding liver lesions. I went to see a liver surgeon yesterday about my lesions. I need another opinion. Just to update, I am a 41y/o WF. Non smoker/drinker. I have had many tests done including abd CT, MRI, liver spect scan, liver enzymes, AFP, CEA etc. All of these have come back WNL. The surgeons are about 95% sure I have 2 adenomas as opposed to FNH. They are about 2.5cm. One is in segment 6. The other is very central next to the portal vein and vena cava. All I have read states adenomas need to come out because of cancer risk. How much percent is the actual risk of them turning to cancer? The surgeons believe the risk of surgery would be much greater at this point. They said they may have to take out that whole lobe and the recovery would be long. Is there a more current technique to remove these that might be less invasive? Wa are going to repeat a MRI in 3 months and just have a "wait and see" approach. Does that seem reasonable to you because I kind of feel like I'm sitting on a time bomb. They also said that adenomas do not usually rupture unless they are over 5cm. Does that also sound right to you? Any info would be great!

[Kevin Pho, MD]

The studies have varied as to the frequency adenomas transform to malignant cancer.  This ranges from 8 to 13 percent.  

Surgical resection is normally indicated, but it sounds like due to the location of the adenoma, this may be a difficult procedure in your case.

Sometimes angiography is used to help with diagnosis, but this is more rarely indicated, especially since you have had a pretty comprehensive evaluation.

I cannot comment on treatment options without reviewing the case.  Repeating the MRI periodically should be done at minimum.  As for a surgical procedure, another opinion at a major academic medical center should be considered.  

These options can be discussed with your personal 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.
kevinmd_

[MissySue0710]

I am a 34 BF with 5 liver lesions.  It is thought that the large (6CM) one is actually an adenoma.  I have had the MRI, and CT scans.  My adenoma is also surrounding the major blood vessels and I have been told that surgery is bad option.   I  also have the hurry up and wait theroy going on right now.  My issues surround pain.  It is daily.  I also have nauseau and other symptoms going on.  My concern is that adenoma is bleeding and I do not know it.  How often should I have a new scan or visit my liver doctor?

[mom691417]

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