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Liver Lesion - confusion over multiple scans - help!
Back in 2003 I got an MRI for idiopathic pancreatitis which showed an incidental 1 cm liver lesion. A year later I got a contrast CT in 2004 which again showed this same 1 cm lesion on the inferior tip of the right lobe which was listed as "most likely benign, small hemangioma."
No follow up was done and in 2008 I had another MRI of the abdomen for unrelated symptoms which showed this same spot again but this time in measure 1.5 CM. Again nobody told me to get it checked and I went on about my life. 2 years later In Feb 2010 I got gallbladder US which showed the same lesion again and my new GI ordered an MRI with contrast to check out this lesion as a hemangioma. The results came back as unchanged/stable than 2008 MRI. It was slightly hyperintense on T2 but not as bright as usually seen on hemangioma. It did not demonstrate enhancement on contrast but showed some peripheral filling in the post contrast images. Most likely a cyst or atypical hemangioma. My GI doc showed it to another radiologist who concurred but said it could be slightly larger so said recheck in a year. I weighted a bit longer to get it rechecked and just got a follow up MRI last week.
That MRI (a year and a half later since 2010 MRI) shows no growth since 2010 but again shows a solid mass high on T2 and low on T1. Mild peripheral enhancement on delayed images. Most likely differential diagnosis is atypical hemangioma. My GI doc had said if it hasn't grown since the last study we can probably stop watching it. However, he's now saying, "I really still don't know what this is and hemangiomas don't grow at all." He's telling me I could see a surgeon for a consult on what he thinks it could be or just re-check it in another year.
I'm very worried and concerned. Does this sound like something cancerous since it has grown slightly, albeit at most only .5 CM over an 8 year period and not at all over the last year and a half? Thanks,
No follow up was done and in 2008 I had another MRI of the abdomen for unrelated symptoms which showed this same spot again but this time in measure 1.5 CM. Again nobody told me to get it checked and I went on about my life. 2 years later In Feb 2010 I got gallbladder US which showed the same lesion again and my new GI ordered an MRI with contrast to check out this lesion as a hemangioma. The results came back as unchanged/stable than 2008 MRI. It was slightly hyperintense on T2 but not as bright as usually seen on hemangioma. It did not demonstrate enhancement on contrast but showed some peripheral filling in the post contrast images. Most likely a cyst or atypical hemangioma. My GI doc showed it to another radiologist who concurred but said it could be slightly larger so said recheck in a year. I weighted a bit longer to get it rechecked and just got a follow up MRI last week.
That MRI (a year and a half later since 2010 MRI) shows no growth since 2010 but again shows a solid mass high on T2 and low on T1. Mild peripheral enhancement on delayed images. Most likely differential diagnosis is atypical hemangioma. My GI doc had said if it hasn't grown since the last study we can probably stop watching it. However, he's now saying, "I really still don't know what this is and hemangiomas don't grow at all." He's telling me I could see a surgeon for a consult on what he thinks it could be or just re-check it in another year.
I'm very worried and concerned. Does this sound like something cancerous since it has grown slightly, albeit at most only .5 CM over an 8 year period and not at all over the last year and a half? Thanks,
MEDICAL PROFESSIONAL
neoplastic=cancer
Thank you so much Doctor for your response but I'm not clear what you mean by "neoplastic lesion".
MEDICAL PROFESSIONAL
i do not think this is a neoplastic lesion from what you describe. however, for peace of mind i suggest that you see a hepatobiliary surgeon at a university or liver transplant center as they will have enormous expertise in managing such lesions
Doc- Any insights? I'm really stressing over my GI's flip flopping on this lesion. Thanks,
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