cirrhosis and large mass on liver

[BuckeyeMike555]

I have been having back pain and right side pain for several months. I mentioned to my doctor that I had a Large lump under my rib cage. A US and Ct both show a mass on the liver 17x12x10 cm  and cirrhosis, both mentioned Hepatoma or  hepatic Neoplasm. My GE recommended a biopsy. They took over 8 days to get him the results, they  said I had cirrhosis and made no mention of the Mass?  GE said  it could be a nodule but has never hearld of on this large. He doesn't believe the biopsy because US/CT show the mass and he can feel it. He is suggesting I go to Cleveland Clinic next.  Has anyone had a biopsy that fells to mention this large mass?

[nan535]

Hector
As usual, you provide great, informative, helpful information.

So happy to read you are cancer-free. Just wondering if there is a reason why you expect to wait 6-9 months for a transplant?

Nan

[BuckeyeMike555]

Thanks for the insight.  I should have added that I am a diabetic and suffer from Congestive Heart Failure, although My heart has gotten stronger the past year. I am on all kinds of heart meds and use Humalog insulin pen before each meal. Diabetes is pretty much under control. When I switched to the humalog I put on alot of weight and am now following a combined Heart/Diabetic diet from the hospital. I'll keep you psted. Again Thanks fro the support.

[HectorSF]

Hi. Thanks for the information. Seeing a hepatologist and oncologist sounds like the right approach at his time. They should be able to have a definitive diagnosis for you and will let you know what options are available.

I guess I should mention that I have hepatitis C, cirrhosis and liver cancer just so you know that I have experience with these diseases. I have had 2 HCC tumors. both about 2 cm in size. One on my left lobe the other on the right. A had T.A.C.E treatment for both. The tumors were obliterated by the chemo treatment. I have now been tumor free for 4 months. I hope to get a transplant in the next 6-9 months.

I am glad the doctor is concerned and realizes that it is important to have world-class experts such as the docs at Cleveland Clinic evaluate your condition.

"Confirmation of a large infiltrative hepatic lesion and lobular hepatic contour. Hepatoma or other primary hepatic neoplasm is of primary consideration."  

Translation:
The CT scan means it is confirmed that there is a large lesion of of cells other than liver cells and retraction of the liver body near the lesion. Hepatocellular carcinoma (HCC - cancer that arises in the liver from cirrhosis) or other liver carcinoma is what should be of major concern.

I hope the pain is not too intense. As a person with cirrhosis you can take Tylenol. Tylenol (Acetaminophen) is safe if you take less than six 325 mg tablets each day (2,000 mg per day).
Patients with cirrhosis should NOT take Non-Steroidal Anti-Inflammatory Drugs (NSAID) such as Advil (Ibuprofen), Motrin (Ibuprofen), or aspirin-type drugs.
If you need stronger pain relief Hydricodone which includes 325 mg of Acetaminophen. Please talk to you doctor.

This is a difficult possible diagnosis for anyone. I would encourage you to find support from our family and friends. Even though they won't understand everything you are going through it is good to be around others and try not to dwell on your illness all the time. Many people can get depressed when they have a serious illness so if you start feeling not like your old self and start to withdraw and lose interest in things you used to enjoy please consult a doctor for help. It is not a sign of weakness it is a normal reaction to a serious situation.

Cleveland Clinic will be aware of all these issues and will have the resources to help you both medically and mentally. A large part of any serious illness is about how we deal with it psychologically. I am glad you will seen at one of the best hospitals in the country.

Hang in there!

Hector

[BuckeyeMike555]

Just set appointment with oncologist and heptologist at Cleve Clinic next week. The GE said he" didn't believe that the biopsy actually sampled the tumor."  He said the biopsy showed cirrhosis but no mention of the tumor. That's why he wanted to move on to the Clinic. He said he would not feel comfortable telling me it was nothing, when the CT shows a large mass and he can feel it.  The blood work was all normal, but he said it could still be something without not yet effecting the liver.  The CT report says:
"Confirmation of a large infiltrative hepatic lesion and lobular hepatic contour. Hepatoma or other primary hepatic neoplasm is of primary consideration."  I was just so surprised that the GE did not belive the biopsy, but I rather be safe than sorry so the Clinic is the place to go. I'll keep you advised.

[HectorSF]

HCC can be diagnosed radiologically, without the need for biopsy in the vast majority of cases. Only if there is a discrepancy between imaging techniques should a biopsy be obtained.

'A US and Ct....both mentioned Hepatoma or hepatic Neoplasm.'
What do they say about it? Do you have a copy of the US and CT scans reports? If so you could post exactly what the report says so we can understand what was found.

What is your AFP blood level? AFP in combination with the imaging are how HCC is diagnosed.

Since you are being refereed to the Cleveland Clinic I would guess that your doctor realizes that this is beyond his expertise. Which is a good thing. You need to go to a liver transplant center as soon as possible to get a proper diagnosis.

I would encourage you to get an appointment ASAP at Cleveland Clinic. They are one of the best liver disease centers in the entire country. They are very experienced in diagnosing lesions and determining its nature.

I wish you the best of luck. Keep us informed of your progress.
Best wishes!

Hector