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Gastroenterology  (Expert Forum)
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What type of follow-up should I have after liver (tumor) surgery?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.

What type of follow-up should I have after liver (tumor) surgery?

by joaniep21, Jun 02, 2005 12:00AM
In 2001, I had classical gallbladder pain and ultrasound revealed while the gallbladder did have some small stone, the pain was from a large mass on my liver. After a CT scan, then a CT guided biopsy and subsequently a surgical biopsy (when the gallbladder was removed) pathologists were unable to differentiate and diagnose the tumor. I subsequently had the tumor and the left lobe of my liver removed. Local pathologists were still unable to diagnose but thought it was carcinoma. They did send a specimen to the Armed Forces Institute pathologists who determined that it was an angiomyolipoma - a tumor usually found on the kidneys.  In 2004, my brother (my only sibling) had abdominal pain and it was discovered he had a kidney tumor.  They removed the kidney and the tumor turned out to be a angiomyolipoma.

My questions are:
   1)  What type of follow-up should I have?  Ultrasound? How often?  I have read that these tumors sometimes re-occur and may then be cancerous.  
   2)  My bother's surgeon told him that our children (now in their early 30's) should be screened sometime.  Is this a hereditary tumor?  And if not, what casued both of us to have it?
   3)  Why was it so difficult for the pathologists to determine what my tunor was?  It took over a month to get results and the wait was very stressful.




by Kevin Pho, MD, Jun 04, 2005 12:00AM
To answer your questions:
1) You're right in that angiomyolipomas most commonly affect the kidney.  There is no surveillence guidelines for post-op liver removal of this tumor.  However, I would suggest periodic ultrasounds to ensure it does not recur.  The ideal period between ultrasounds has not been studied.

2) There is a genetic component to these tumors.  You can discuss family screening with your personal physician.

3) I cannot speak for the pathologists.  Pathological diagnosis can depend on the particular sample that was taken, and whether they asked for another opinion or not.  

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.
Medical Weblog:
kevinmd_b
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