Unexplained Liver Lesions

[MIDAS]

Please help. Otherwise healthy 37 year old biracial male with occassional colds and 1 bout of acid reflux this summer. In April 2003, CT scan for unrelated hernia and Dr saw lesion/cyst on liver and said probably not big deal but check with Dr. I will quote from Dr notes  - - -
October 2003-ultrasound of liver ---2 echogenic lesions noted within liver, one in left lobe[segemnt 2/3] and approx 1cm. 2nd lesion in right lobe, inferiorly-segment 5 and size -1.4 by 1.1 by 1.3 cm. When compared to report for CT scan, most likely represent hemangioas of liver. No other hepatic lesions noted. The small 7mm lesion in dome of liver described in CT scna not visualized. No evidence of gallstones, wlall thickening or surrounding fluid...no evidence of intra or extrahepactic biliary dilatiation is identified..right kidney demonstrates no evidence of hydronephrosis....November 2003 MRI done--5 lesions within livere which are decreased signal on T-1 and increasing T-2 images. Largest lesion within segment 6 [10mm x 14mmm]of liver as well as 2 lesions within segment 2 [10mm each]...smaller lesion is noted within dome of liver [9mm and is not visualized on all sequences. Lesions demonstrate peripherral enhancement on post gadolinium images, however do not demonstrate typical enhancement pattern for hemangioma. Probable cyhsts noted within right mid-pole of kidney as well as upper pole of left kidney.
English please. Where is this going? Liver disease, benign cysts, cancer? Hints? What does this sound like? Please be candid because the medical jargon is confusing.

[Kevin Pho, MD]

Erin, PA has kindly answered your question in her comments below and I agree with her assessment.

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.

Thanks,
Kevin, M.D.

[GI.PA]

First..it is hard to do this without looking at the films...but on first glance of your story.  

You can get running in circles on the liver lesion thing.

Lets review the facts:
4/2003 CT said liver lesions
10/2003 Ultrasound said liver lesions and when looking at both studies together said they look like hemagiomas.
11/2003  MRI said...yada yada..still have spots in the liver.  May or maynot be hemangioma.

Here is the key.  You and your doctor need to make sure nothing is growing in the liver (worse case senerio liver cancer or a spread from another organ to the liver).  Getting an alpha-fetoprotein (a liver cancer marker) and liver enzymes can help everyone feel better.  Then, your doc can call the radiologist and ask "Dr. Radiologist...what study would your reconmend to follow this and how often".  They will most likely say "ultrasound" and "every few months to assure stability".

The WIDE majority of "liver lesions" are simple hemagiomas or benign liver cysts.  Both of these do not cause pain and are not typically biopsied.  

You must remember, each of the imaging studies, CT, US, and MRI each have different ways of looking at the liver and comparison between two types of studies may lead to confusion as some pick up smaller lessions and others give different characteristics.  The more tests done the more conflicting descriptions you will get on these lesions.  In my experience, it is good to do these studies initially but getting a feeling from the radiologist which study gives the best picture of the liver (based on your body type and lesion position) and then using that modality to follow the lesion, is usually the best, and least confusing approach.

Personal followup with your doctor is essential.

GI.PA
Erin

[MIDAS]

I failed to add that all of the blood tests were normal. I'm sure what a marker is that you mentioned.

[bbmax]

I too had hemangiomas (probably...possibly something worse) dx 5 months ago. I had LFTs and AFP then and also 2 days ago. Both normal (AFP was 2.6). Does the fact the tests stayed stable over 5 months mean I am proably in the clear? Hope all of us just have hemangiomas!!! Thanks for everyone's help. It sure shakes you up when something as scary as this comes up. Let us all be grateful for good health!

[GI.PA]

With x-ray findings more consistant with hemangiomas than other stuff and a normal AFP...this would lean toward a favorable outcome.

GI.PA

[whisperfare]

Hi new here. I have had CAT scans, ultrasound, and the SPECT done to determine if a spot on my liver was a hemoangioma. Well the SPECT showed that it was but then it picked up more lesions scattered about my liver that did not show to be hemoangioma's. Now the Radioligist has ordered a MRI on the liver to look at the other lesions. If there is one hemoangioma is it a better chance that the other spots are also that, and if yes why did they not look the same as the one that is a hemoangioma(sp).
I have an autoimmune disease that is of unknown type except it is of connective tissue may have more than one since my nerves and muscles are affected. May also be Lupus in there. I also have some problems with my lungs.
Is there a good chance that my liver just has hemoangioams that did not show up right like the other one? Can you have cancer with the angioma, can Lupus and others like scleroderma cause lesions or spots on the liver.
I have my MRI on thursday and see my primary doc on Friday. Then I guess I get another specialist added on for my liver. Any ideas would be great. I have had these problems since 1995.
Thank you
C.H.

[bertnernie]

My wife went into emergency for stomach pains and the US (for possible gall stones) uncovered lesions on her liver.  I'm not a hypochondriac by any means, but I am worried about where this might lead to.  I am glad I found this site as the information regarding hemangiomas has somewhat lessened my worries.  Anyways, my question is, "How many different possibilities could theses lesions lead to?"  Thank you.

[bertnernie]

My wife went into emergency for stomach pains and the US (for possible gall stones) uncovered lesions on her liver.  I'm not a hypochondriac by any means, but I am worried about where this might lead to.  I am glad I found this site as the information regarding hemangiomas has somewhat lessened my worries.  Anyways, my question is, "How many different possibilities could theses lesions lead to?"  Thank you.