Liver Lesions Found

[Benson]

What causes liver lesions. How common are they? Is there any significance in the the number of lesions seen? How often do they change into liver cancer? Is there any treatment that will help? (Alternative or mainstream)

[Kevin Pho, MD]

There are many causes for liver lesions.  They can include malignant causes such as cancer, or benign causes like cysts, hepatic adenomas, hemangiomas, focal nodular hyperplasia, or infectious causes.  

As for the frequency, it will depend on what kind of liver lesion is in question.  I would say that benign causes of liver lesions are more common than malignant ones.  

The number of lesions does not normally point to a diagnosis.  The best way for further evaluation would be imaging such a CT scan or MRI or biopsy.

To my knowledge, benign liver lesions do not "change" into cancer.  It is either cancerous or not from the beginning.  

Treatment would depend on what the lesions are.  Some lesions, such as cysts are simply observed.  Other lesions may be resected, based on what it is and the size.  

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.

***I will be away and have limited internet access from December 26th to January 4th. I wish everyone a safe and happy holiday season.***

Take care,
Kevin, M.D.

[bbmax]

Since the doc is away, I will try to give you some information. I am a nurse but am posting as a patient. I had a CT scan for a hernia check and "liver lesions" showed up. I have no symptoms and lab work indicates no problem with my liver. Lesions are often cysts or non-malignant "masses" called hemangiomas. You may need testing to differentiate what your lesions are. Biopsy of the lesions is the most definitive. Lesions are rarely liver cancer as the primary site except for people who are heavy drinkers or who have had hepatitis. Other possibilities are the lesions are metastasis from another cancer site ie lung, colon, or breast. The most likely scenario is that the lesions are NOT cancer but you need to get more information. Your posting does not indicate how the lesions were found or if you have any symptoms of illness. You can search archives on the board for more info on liver lesions. I hope you may be a little more relaxed after reading this as I remember how I felt when the surgeon mentioned "liver lesions". I have had follow-up CTs and will have another one in February to see if there are changes. The CTs are not always able to make a "for sure" definitive diagnosis so I chose to do the followups rather than have biopsy.
Good luck and please post with more information if you want to.

[bbmax]

Just to add on, hemangiomas are very common but usually we would never know we had them unless we have a CT scan or MRI. Multiple lesions that are benign are common and do not increase chance of it being cancerous.

[Benson]

Thank you for your comforting words....I did not even know there were liver lesions except for cancer....so I have been very
scared.

I had a CT scan....all cysts were benign...but could not see
two very well...so I had a MRI....same deal the two could not
be called as benign or malignent.  Red tag hemagioma test was
negative.  I saw the Gastroenterologist yesterday and I am scheduled for a liver biopsy on Thursday.  He said he thought
I was about 99% on the benign side because I have had no symptoms and my blood work was normal.  Physical exam was
all normal.

The two lesions in question were the smallest of all...do you
think that could be the reason they are not being read easily.

I am of course still very nervous even tho' my Doctor seem to
give me a favorable outlook.  He said think of these as if you
saw a bunch of grapes on a table and couldn't see two....wouldn't
you assume the two you couldn't see were...grapes?  So, it stands
to reason we have two more cysts.

Any comments?       Thank you for the comments.


p.s.  I am a middle age woman, healthy....small ache occasionally
in my side.  I have just had a mammogram.  I have had a total
hysterectomy.   These were found on a routine ultrasound for
gallbladder.  Gallbladder was normal.  Thanks.

[bbmax]

Benson, I know just how you feel but you are more in the clear than I am as I did not have an MRI. I am just having the follow-up CT on February 25 and am nervous too. It is such a life-changing diagnosis if the lesions are not benign that anyone would be scared. It is like when you get an HIV test routinely for insurance and you have virtually NO chance of being positive BUT you are scared because the implications of a positive test are so profound. I opted to just do the follow-up CT as I did not want a liver biopsy (no reason except I just didn't want it and I have heard that even a biopsy might not be conclusive). Did you have the AFP lab test and was it OK? That relates to tumor activity. I almost hate the whole CT technology because it finds a lot of things that are benign that you would never know you had if not for the CT. The anxiety it generates is almost too much to bear. The nurses I work with used to joke we should get a total body scan but then realized we didn't want to know if anything is wrong! Please let me know what happens with the biopsies. I will let you know about my follow-up CT. I am not really religious but I will send positive energy and thoughts for you. If all turns out well, we should both work harder to appreciate our lives, right?

[Benson]

Thanks for the positive energy!!!  I will do the same your way
wherever your way is!

I don't know of the test that you referred to....I had blood
work done the day that I fatefully went in for a bladder
infection and indigestion!!!!!  The parts of it that I know
are about the liver are as follows:  Bilirubin 0.5,  Alkaline Phosphatase, Serum...81,  AST 13,  and ALT  15.   My Doctor
said all were normal.

You are right, as of Monday, it will be a month and for most
of that time...I have been terrified!  I feel better after
speaking to the Gastroenterologist.....but my GP was hopeless.
He would never call me..and never gave test results.  I learned most of what I know on the internet.  My GP  was sort of a
natural health Doctor as well as an MD....which I liked.  He
wore sandals and had his dog in the office, which I loved.....but
now I realize, when it comes to tests, you want white coats and
stainless steel!!!!!

I have taken estrogen for almost 30 years on the advice of
several Doctors...no progesterone....and I think that has
agravated a preexisting condition.  I have taken myself off of
that.

Anyway,  the odds are on my side.....but the "what ifs"  are
winning the war tonight as I ponder my next few days.

Do stay in touch, with your situation.....and more words of
encouragement...or information.  

Thank you for your message.      Judy

[bbmax]

Dear Judy, is your test tomorrow? If so, take a deep breath and just get it over with. Every time I have gone for a CT, I have felt very humbled and small and "sickly" like all the techs probably felt sorry for me! But I just forced myself to get it done and tried not to worry. I have the tests at the same hospital where I work and then, for good or bad, I can access the results on the computer...that is pretty daunting. Anyway, the AFP is a non-maternal alpha-feto protein test that shows liver tumor activity if it is increased. It is true that hormones can cause liver hemangiomas and maybe liver cysts to grow. As I said before, I wish I never knew about all this!! Liver cancer is almost never found in patients who are not alcolholics or who have had Hepatitis. But my docs thought it might be a spread of cancer from another place...I had the mammogram and other tests and I have no symptoms so I am hoping that it is all OK. It most probably is for both of us. I admit I am now jealous of everyone who has not had a CT and does not know what might be lurking!
I live in SF Bay Area. I am going to go to a naturopath for liver detox advice/diet. I have friends who have had good results from having healthier diets. I will let you know what happens with the naturopath (she had a MD as well).
I will think of you tomorrow....
christine

[Benson]

Christine,  Yes my test is tomorrow around 3:00 p.m.....Little Rock, Ark. time.  So, think of me.  I think they will give me
quite a bit of sedative...so I am trying not to be a baby and
be brave!!!!   I know what you mean.....I hate feeling
like such a pitiful victim when I go get a test.  I am trying
to read something into every word or facial grimace!  I can
tell you one thing....they will have to drag me kicking and
screaming to the next machine that looks inside you!

I have always believed in vitamins and healthy eating....I don't
drink or smoke and if this is a bad report...I am certainly
going to have "egg on my face"....because I have encouraged
this with my friends for years!  We don't have a naturopath
here in Little Rock...but my husband works in Chicago and we
spend our summers there, so I could go for a work up there.
Please let me know what you find out.  I don't know how long
my posting stays on the board, but lets stay in touch...I will
send you my e-mail address if you need it.  

I did see on another site some information, which I did not read,
on chinese herbs.  Honestly, I don't know what to do at this
point....I feel like I am a walking time bomb!!!!

My Doctor says this is very common....I wish I could let that
sink in and feel lucky....but until my test comes back....I
will be..........cleaning out all of my closets...and tying up
loose ends!!!!!   Just kidding.....sort of.   Judy

[maan]

Hi, Im 43 year old male from Maldives (A group of islands in the indian ocean) Some 6 months back when I went to Thailand for a medical treatment, I did a full medical check up. After reading the reports, the doc said there is nothing wrong with my blood, kidney function is normal, liver function is normal, but an enlarged liver, and after looking at the ultra sound report of my liver he said that there is a "poorly defined echoic lesion on the liver" he said it could be tumor mass or a fatty object. When he told me that I felt that Im going to collaps. Since he said that I have this on my mind 24/7, Can you tell me what this axactly means "Poorly defined echoic lesion" Is this dangerous? Im very afraid. Please help.

[bbmax]

First, to Judy, I will be thinking of you. I too try to be healthy and eat right and don't drink or smoke. I think all that is in our favor. Your doc is right and these hard to define but benign lesions are becoming more and more common due to more people having CT scans for other reasons!! In other words, we all could have them and only those of us lucky enough to have scans get to know about them! Liver biopsies are not difficult from what I know so you should be fine tomorrow. Let me know and send me your email.To "mann", I think your report is the same as Judy and mine in that they saw some "spots" that they are not sure of. The odds are they are benign and not dangerous. Have you had liver function tests (blood work)? I had the exact same feeling like I could collapse when my doctor said they founds "spots" on my liver. Look on this web site (search archives") for postings on liver lesions and liver hemangiomas.
My first posting will come up. I know I spent hours on the internet trying to find something reassuring and someone else who had a similar experience. My suggestion is to see the doctor again and have lab work done and a follow-up CT scan which is better at "seeing" and diagnosing the lesions than a ultrasound
(what did your doctor in Thailand suggest?) It more than likely will be nothing bad. Let us know what happens. By the way, I have many friends who have gone to Maldives and I know it is beautiful! I have been to Seychelles and to Thailand as well and love tropical places.

[bbmax]

Sorry maan for getting the name wrong...also I did not notice you said you did have normal liver function tests. I still don't quite get why your  doctor didn't tell you if/when you should get another test to follow-up. You have been worrying for 6 months and not done anything? I know I just wanted to ignore it all but my doctor insisted I have another scan. I figure if you don't have any symptoms of being sick, proabably all is well. Still, another test (the CT scan) might put your mind to rest.
I hope this helps because I KNOW how horrible it is to think you might have a life-threatening illness.

[Benson]

I'm off guys.........wish me well!  "Down with CTs"!!!!!
          
                Judy

[meljean]

In August 2003 I participated in a voluntary heart study program in which I was given a CT scan for the heart which also included a scan of the abdomen.  I received a letter in Dec. 2003 indicating that the radiologist "incidentally" discovered a 10 millimeter low attenuation hepatic lesion on (in?) my liver. The radiologist suggested that it be followed up with ultrasound and another CT scan. Since this study is for research and not for clinical diagnosis, they suggest I follow-up with my personal physician. I did not receive their letter until Dec. 28th and was on vacation in St. Maarten from the 29th of Dec. until yesterday (Jan. 7th). I have been unable to reach my personal physician and am anxious. Could someone tell me a little more about hepatic lesions and what this means. I am not a medical person and would like some info. Thanks very much!

[bbmax]

Hi, read the above postings including the answer from the MD. Lesions are usually benign as we stated in other postings. Once again, those CT scans cause  A LOT of anxiety and I am sure it will be an ongoing problem now that we have this technology and it is being more widely used. Unfortunately, most docs will recommend more studies JUST IN CASE a lesion is malignant. Usually another CT or MRI is suggested to start but nothing (even biopsies of the lesion) is completely conclusive. Often the physicians will look at the total picture of the patient's health and decide it is likely a lesion is benign but they may  be reluctant to be definitive JUST IN CASE. So my suggestion is to try to not worry and to follow-up when you see your own physician.Have him/her interpret the CT results for you. Please post here again when you get some answers and we all will too.

[bbmax]

Look at the above posts including answer from MD. Try to relax. I suspect there are many of us in the same boat worrying (hopefully needlessly) because CT scans pick up things that are benign and very common that we would never have known we had if we hadn't had the CT scan!! The other posts explain the lesions. More tests may be suggested to give a definitive diagnosis but sometimes it is not clear no matter what you have done and you just wait and follow-up with CTs at intervals. If you feel OK, it is most likely nothing. Have some liver function tests (blood work) done and see what that shows. Have your physician explain the CT results to you.

[Benson]

Well all.....I am back after having a liver biopsy yesterday.
I was absolutely scared to death.....I felt like a little girl
in the Doctors office wanting to cry over a shot!!!!!   I didn't
actually cry...but if you had looked closely my eyes were sure
moist!

That was all in anticipation of the procedure.....when I had
it done, it was absolutely the easiest, most painless, invasive
procedure I have ever had done.  Keeping my hands over my head
was the hardest part.  Pain relief these days is so good...so
if any of you have to have this.....don't be scared.

The scary part comes now......test results...I will let you
know.

Christine.....my e-mail address is ***@****.  Just in
case we suddenly disappear off the board.  I especially want
to know about your test...and also share info as we gather it.
If my test is all benign...I would really like to go to Arizona
to the clinic of Dr. Andrew Weil (spelling?)...and get a work
up and then a recommendation on vitamins, etc.

I hope all of us are ok.....for those of you whose Doctors have
just sort of let it drift on without forcing the issue on more
tests......I always feel like in this day of lawsuits...they
must not be too worried about you!  If that is any comfort.

Lets all stay in touch......it is true....."misery loves company"

Send good thoughts my way this afternoon, as I wait for my
results.

  Judy

[maan]

Hi, many thanks for your reply. Infact Im planing to go to Sri lanka at the end of the month or early February. I will do an ultra sound therapy once again, or do you suggest me to do a CT?

If you ever decide to come to Maldives do just let me know.

[Benson]

Maan,  I thought I would comment on your reply to bbmax...who
has been so helpful and comforting to all of us!

I have had all of the tests now....and only had to have additional ones because I had so many benign cysts in my
liver that there were two smaller ones that they could not
call as benign or malignant and that is what I had biopsied
last Thursday (still don't know the results).

I do have a lot of information on cysts, hemangiomas, and other
benign lesions on the liver.  As you can read they are very
common (I did not know that)...and seem to be a lot more scary
for all of us than for the Doctor.  I know what ever the Doctor
says in the way of comfort or reassurance will not take away
your terror over the "what ifs"....but hearing from people
with the same problem does give us all a little comfort.  Feel
free to e-mail me to the address I gave bbmax in an earlier
posting......if and when this  posting disappears.  

Life can be very scary...and we all think we have some control
over our health...but up to a point...and then it seems to
be totally out of our hands.

I will be thinking of you.      Judy

[maan]

Hi Judy, Many thanks for your response. Do let us know how your results come out. I hope and pray that everything will be fine with you.

In case you want to write to me, my email is ***@****

Take care
Maan

[Benson]

Hi Maan,  I will certainly keep your e-mail address and we
will stay in touch, as well as Christine....and support each
other.

This last month has been the most terrifying that I have ever
spent....the anxiety is almost overwhelming.  I haven't been
able to go about my daily activities and I haven't really
wanted to see anyone.  I hope my answer today and tomorrow
will be positive so that I can resume living.

I have enjoyed hearing from the three of you...it has kept me
going.

More later, hopefully good news.

Judy

[Benson]

Well all,  I did not have good news.  I do have liver cancer.
The cysts that they could see clearly were benign, but the two
that they could not identify were cancer that looks like it has
come from the colon or stomach.

I am sorry to tell you all this, because I know it will scare
you.....but this is very uncommon and I am sure you will all
have normal cysts or hemangiomas.

I go for more tests to see where the primary site is..on Friday
and then next week I meet with the oncologist and begin treatment.  My gastro doctor was positive and asked me to be
the same....because of my blood tests being normal and no symptom
even tho it has metastasized....they think it is small and early
and I will respond to chemo.  Miracles can happen...I know....but
we are all stressed and devastated.

I wish you all the best and thank you for being such a support.

    Judy

[maan]

Judy,

Just have faith, be courages and im sure you will be just fine
I pray for God to give you a speedy recovery....

With lots of love
Maan

[bbmax]

Judy, I sent a message to your private email. I want to second maan and his simple sentiment. I feel you are a great person and deserve it all to be OK in then end. Please try to be positive. God knows it isn't easy and I know I would also be (and will be if it happens) devastated with the news you received. I think it must be good that you have no symptoms. Most people never know early enough that something is wrong. I had a friend who had an ovarian cyst. They did the surgery to remove it and the surgeon decided to (as a precaution) get some fluid from her abdomen to check for any chance of malignancy. It just happened that she did have the beginning of ovarian cancer that was totally unrelated to her ovarian cyst. Never would have been found if not for the cyst. This all happened 16 years ago and she is fine despite positive lymph nodes found at the time. She had chemo and was not even that sick. She still worked as a nurse and hardly missed much time. She is the one on the raw diet recommended by her naturopath. Go to the library and look for books on naturopathy. They have lots of good ideas for diets to support more traditional treatment of cancer. Or check the naturopath websites on the web and you can even order information. I am going to see the naturopath soon and get a liver detox diet. I will send any information if you are interested. Let me know if you need any other support.
I am thinking of you.

[Benson]

cHRISTINE,  i HAVE NOT RECEIVED YOUR E-MAIL....i HOPE i DIDN'T
DELETE IT BECAUSE i DID NOT RECOGNIZE IT, BECAUSE i REALLY EJOY
HEARING FROM YOU.    aGAIN...MY E-MAIL IS ***@****.

i HAD A SURREAL DAY YESTERDAY...BUT i AM GRADUALLY COMING TO
TERMS WITH WHAT HAS HAPPENED.  i HAVE A COLONOSCOPY AND ENDOSCOPY
TOMORROW TO FIND THE PRIMARY SOURCE.  i HAVE REALLY HAD NO
SYMPTOMS....AND ALTHO' IT IS IN MY LIVER WHICH i DON'T UNDERSTAND
HOW IT COULD HAVE METASTASISED? THERE IF THE PRIMARY LESION
IS SMALL.....THE TWO LESIONS ARE SMALL 2 CM. AND THEY DID NOT
SEE ANYTHING ON MY MRI IN MY KIDNEYS, PANCREAS OR i GUESS IN THAT
GENERAL AREA.....THAT WAS BIG.  iT MAY BE SMALL IN THAT AREA.

iT MAY BE IN MY COLON.  wE HAVE AX EXCELLENT, WORLD RENOWNED
CANCER TEACHING HOSPITAL HERE.  eVERYONE THINKS aRKANSAS IS SUCH
A "HICKY" STATE, AND MUCH OF IT IS VERY RURAL....BUT lITTLE rOCK
IS BEAUTIFUL AND IN SOME WAYS QUITE "WITH IT".  bUT FOR SOME
REASON....THE uNIVERSITY OF aRKANSAS mEDICAL cENTER....ESPECIALLY THE cANCER RESEARCH CENTER HAS BECOME VERY
WELL RESPECTED.  i ALSO HAVE FRIENDS WHOSE DAUGHTERS ARE DOING
RESIDENCEY, ETC. IN nEW yORK AND bOSTON WHO HAVE OFFERED THEIR
ADVICE IF i NEEDED IT.

i WILL CHECK OUT THOSE SIGHTS....AND i WILL FIGHT, FIGHT...AND
NOT GIVE UP.  tHIS IS MY TIME TO PROVE MYSELF...LIFE CAN NOT
ALWAYS BE EASY.  cHRISTINE, PLEASE STAY IN TOUCH...i HOPE TIS
IS NOT DEPRESSING FOR YOU......THE dR. SAID THIS TOTALLY CAME
OUT OF THE BLUE AND THE TWO LESIONS NEVER DID LOOK THE SAME AS
THE CYSTS THAT HE SAW.  

tO mAAN, IF YOU ARE READING THIS...THANK YOU SO MUCH FOR YOUR
THOUGHTS...i HOPE YOU ALSO, WILL STAY IN TOUCH WITH ME.

i INTEND TO FIGHT THIS UNTIL A CURE COMES ALONG.

tHANK YOU BOTH, AND PLEASE E-MAIL ME...IT HELPS.

jUDY

i DON'T KNOW WHAT IS WRONG WITH MY COMPUTER....THE LETTER SEEMS
TO BE JUST DOING WHATEVER THEY WANT!!!!   jUDY