How serious are these liver tumors?

[momto2]

Hi! I will try to be brief. I am 42y/o female. I was found to have 2 liver tumors about 1 and 1/2 years ago by accident on CT scan. I was seen by a GI doc and transplant surgeons. They all thought these were adenomas and decided to just watch them. 4 MRIs followed with no change. Liver enzymes are WNL. AFP, CEA etc. all normal. A year after diagnosis I went to a liver specialist at Vanderbilt Hospital. He took one look a my CT and said they were not adenomas but FNH. We did more labwork which included a PT level this time. PT level was 15 but everything else was again WNL.He recommended no further followup. Along the way I had 2 ABD US. The tumors did not show up on US however the first US report said I had fatty liver. My questions are... Should I just go with the liver specialists Dx of FNH even though all the other docs thought adenomas? (this specialist came highly recommended). My PT level was slightly elevated. I was told it can be elevated with liver problems. Is it high enough to warrent concern? Finally, I don't know what to think of the fatty liver Dx. The second US was fine. My labwork has been fine. It was never mentioned on CT or MRI but they were probably just looking at the tumors. Should I assume I have it or not? I am not drastically overweight but have had high triglycerides before. Any input would be great!

[Thomas D Schiano, MD]

I WOULD NOT WORRY ABOUT THIS PT LEVEL.  I THINK YOU CAN CONTINUE WITH THE SERIAL MRI FOR NOW.

[momto2]

Thanks so much for your reply. I just wanted to confirm what you said. Do you think I should continue with serial MRIs after a year of no growth on the tumors? Also, Is there anything to be concerned about with a PT of 15? Thanks so much for your time!

[Thomas D Schiano, MD]

FNH is generally easily diagnosable on MRI although at times can be difficult to differntiate between adenoma.  rarely focal fatty sparing may also look like tumors. directed biopsies may help to differentiate them but there is a high false (-) rate.  typically we follow serially with scan looking for any interval growth.  if you take oral contraceptives or hormonal replacement they should be stopped. U/S I think are relatively low yield for these type of lesions.

i hope this is helpful