Avatar universal
Liver lesion discovered. Terrified, please help.
Hello everyone,

I've been poking around these boards, reading any topics which I can find that seem relevant. But any information/advice/consolation you can offer would be most appreciated.

I had an abdominal ultrasound last week, after my liver enzymes came back slightly elevated (I had a doctor who was screening everything, while ruling out autoimmune diseases/cancer). Everything else was normal, and he said my enzymes were just a little above normal. I know that my cholesterol is also high, and has been for a while. I am a 25 year old female with PCOS, and I've been on oral contraceptives (most of the time) since I was 17. I have read all about the link between liver adenomas and the pill.

My doctor expected my ultrasound to maybe reveal some fatty liver. Instead, this is what came back:

"Liver is mildly heterogeneous in echotexture. In theposterior segment
of the right liver lobe is a well-circumscribed, hyperechoic,
homogeneous 3.3x4.8x4.5cmlesion with no significant flow on color

The pancreas is unremarkable; the distal portion is obscured by
overlying bowel gas. The gallbladder is sonographically normal, and
no gallstones are seen. There is no intra or extrahepatic biliary
ductal dilation. The common bile duct is normal at 4mm.

The kidneys are sonographically normal. The right measures 11.5cm and
the left measures 11.5cm. The spleen is at the upperlimits of normal
in size, measuring 12.5cm.

The abdominal aorta is normal. The retrohepatic IVC appears
1. Indeterminate lesion in the posterior segment right liver lobe.
Differential considerations include hemangioma, adenoma, and FNH.
Because the lesion is very well-circumscribed, focal fat deposition
is also a consideration; however, this is felt to be much less likely.
2. Heterogeneous hepatic echotexture.
3. Follow up imaging with contrast enhanced MRI is recommended if no
contraindications are present."

I have an MRI with and without contrast scheduled for Feb. 13th, and then I'm meeting with a hepatologist for the first time. Until then, I am absolutely terrified. I keep having panic attacks, despite my best efforts to stay calm and positive. I probably sound ridiculous, but can anyone offer any information? I'm absolutely terrified that it will be something really scary like cancer, and I've never had major surgery, so the idea of having to have an operation on a major organ sounds horrifying. I am not having any real symptoms, except for a feeling of fullness sometimes in my abdomen, which I always thought was gas.

Any help is sincerely appreciated. Thanks for taking the time to read this.
1 Answers
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Avatar universal
Hello and hope you are doing well.

Understand your predicament. As suggested it could be a hemangioma or an adenoma, it could also be a cyst, but his gives hypoechoic shadows. Depending upon the echogenicity, the borders and the shadows created a near correct diagnosis can be made with imaging studies. This is again correlated with the liver function tests. So, after the MR, if there is a doubt then a liver biopsy may be needed. Again a follow up may be mandatory to see for changes in the lesion.

Hope this helped and do keep us posted.
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