I have been diagnosed with a hepatic adenoma in the left lobe of my liver near the dome of the diaphram. It measures 1.4 x 1.7 cm. I have a tremendous amount of pain at the base of the right rib area. Does anyone know if this is normal? I have been advised by my gastro dr not to take meds of any kind if possible. He does not want to biopsy or remove at this time. Should I seek a 2nd opinion and should I be seeing a different specialist?
The hepatic adenoma is a benign tumor. Your doctor avoids biopsy because these tumors may bleed badly when punctured. He does not recommend surgical removal because he probably thinks it's too small (less than 5 cm).
However, just to be on the safe side, you should probably seek a second opinion from a hepatologist, specializing in liver cancers. The main reason is that hepatic adenoma may be difficult to distinguish from hepatocellular carcinoma (HCC).
The catch 22 of early liver cancer diagnosing is that the biopsy needle may "seed" cancerous cells from the tumor (IF it turns out to be malignancy) in the rest of the liver and speed up the cancer metastasing. So often the approach is to wait and see - by ultrasound and CT scan or MRI - for 3 or 6 months whether the abnormal mass grows or not.
Also, you should regularly check your AFP. Very elevated AFP may suggest HCC. A HCC may start growing in an initially benign hepatic adenoma.
If you have HCV and cirrhosis, your HCC risk is also increased.
So you may consider surgical removal, even though your adenoma is small (or precisely because of that) in order to avoid future complications, including the risk of sudden rupture and internal bleeding.
Another possibility may be destroying the adenoma by ultrasound guided tumor ablation.
In making all these decision, you should seek a second and even third opinion, if necessary.
You can also check out these threads in the forum about AFP and the HCV/HCC connection:
I do not have hepatitus but have been diagnosed with a hepatic adenoma. I also have ideopathic thrombocytopenia where my platelets go low for no known reason and I bleed like crazy. having both I am scared the adenoma will rupture and bleed without me knowing it. how likely is this to happen? should i have the adenoma removed because of this reason?
i have 3 tumors in liver focal nodular hyperplasia or hepatic adenoma doctors not sure which one. After 2 years know have adrenal lesion as well. scheduled of another scan in 3 months. Can not find any info. on have tumors in liver as well as adrenal gland unless it is metastes any ideas if this is normal of adenomas to be in both places.
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