CT Scan Question

Hello,

I am 36, good overall health, non smoker, non drinker.

I was having Acid reflux in July of 2009 and my Dr. sent me for an ultrasound test.  The test revealed what was believed to be a 5.9 cm hemangioma on the hepatic portion on my liver.  I don't have any readily noticable symptoms from this lesion.  My doctor did suggest that I got to get a CT scan of my liver, but since he was very certain it was a hemangioma, I did not immediately go for the CT scan.

I recently decided I should go and have the CT scan done, (Oct. 27th) and received a very conflicting report from the Radiologists.  The first Radiologist to review the CT scan said the following:

"There is a 6.8 cm hypodense mass in the posterior segment of the right hepatic lobe which is also lobulated and appears to contain some nodular foci of enhancement along the inferior aspect of the lesion.  This does not have the typical imaging appearance of a hemangioma.  Further evaluation with contrast enhanced MRI is suggested prior to consideration of biopsy."

My Dr. had some questions regarding the test, and called the Radiology group to speak with the Radiologist who wrote the opinion stated above.  He was not available at the time, so another Radiology looked at the scans and stated the following in an amended report:

"CT of the abdomen October 27th and the ultrasound July 2009 are reviewed.  The abnormality of interest is stable in the interval of 6 cm.  No further radiographic follow up is recommended."

Needless to say, getting multiple reports from the same Radiology group was discouraging.  My primary doctor agreed, and has sent my scans to (Ultrasound from July 2009 and CT scan from Oct. 27th, 2010) to Cedars Sinae to be reviewed by another doctor.  I am currently awaiting the results of this reading, and hope to hear by next week.

I am quite worried, and just wanted to see if anyone had any advice for me.  Would it make sense to go ahead and have an MRI done to eleviate any questions about what I have, or is the CT scan the better test for this particular issue?  What are the chances that this is something bad?  Any advice would be greatly appreciated.

Thank you for your time and consideration.

[ggreg]

Wait and see what the doc at Cedars Sinai says about your pictures.  I am troubled by your doc calling radiology and arguing the report of your scan.  And I really don't get how a 6.8 cm, which that means your so-called hemangioma grew a little over the period of 15 months was magically changed by your doc's call closer to what it was before.  Also, any lesion that grows is going to change in appearance, which the radiologist described specifically and clearly, and even said that it was not looking like a hemangioma anymore, and suggested an MRI with contrast in preparation for biopsy.

Now, I'll tell you what happened to a close relative.  Three docs (sounds like you) looked at his biopsy slides, two said it was cancer and one argued it wasn't, and thus treatment was being delayed, and finally the patient said to proceed with chemo and set up surgery immediately.  This was done.  He had cancer.  This is not to say you do have it, but it demonstrates that even the best docs can be wrong, wrong, wrong.  So, that's why I say wait and see what the third doc at Cedards Sinai says.  Now, if he agrees with your doc, GET ANOTHER OPINION and go with the contrast MRI this time.  If he doesn't agree and thinks you ought to have a biopsy, well, there you go.

I'm just concerned about your doc influencing evidence the way he did, unless he feels really extra qualified to scrap with a radiologist, which WE don't know if your doc is all that qualified, else he'd be working over at Cedars Sinai.  I hope my advice helps.  Now, as to whether your liver problem or nonproblem is related to your acid reflux, I have no idea.  Looks to me like they'd at least be trying to ALSO understand what is causing that.  I CAN tell you from personal experience the two things that have caused too much acid to where it bubbles up and hurts, and that's some liquids will do it, like store-brand cola, and also some medicines will do it, which taking after a meal will help that.

Keep us posted, I find your situation interesting on account of my relative went thru that.