Aa
4-mm "Spot" on liver
Because I have a measurable level of AFP (which fluctuates between 12-20 ng over the last 4 yrs), my doctor ordered a CT scan; I'd had 2 previous ultrasounds to check for tumors. Today's CT scan showed a 4-mm spot on my liver; now I have to go back for an MRI for further analysis. Other than the worst-case scenario (tumor/HCC), what else could this be? I'm actually not too freaked out (yet), but am curious if anyone's had anything similar turn up in their scans. Thanks!
I am being treated for Breast Cancer as a routine while on treatment they gave me a scan on my liver and found something and this resulted on me being recalled for a US scan which I just got the results today and like you I was told it was a 4mm benign haemangioma and that it was not necessary to do anything unless it grew to an enormous size which would cause much pain and if so they would do surgery to remove it but that would probably be unlikely to have to happen so like you I am a very happy person today best wishes with your health Regards
It could definitely be a hemangioma. If it is, then a 4 mm one probably shouldn't be a conceern depending on where it is. I don't know a lot about these, though I had one, but they do not usually grow fast like HCC tumors can. They are not malignant. I know of at least one case where the hemangioma got so large as to threaten liver failure, and resulted in transplant, but I believe this is unusual.
From imaging they can try to diagnose whether or not it is HCC, but they CAN be wrong without an actual tissue sample. There is the dilemma. If they biopsy the tumor, and it IS malignant, then they risk spreading the malignancy.
Fingers crossed that it stays at 4 mm and is determined to be benign. :-)
From imaging they can try to diagnose whether or not it is HCC, but they CAN be wrong without an actual tissue sample. There is the dilemma. If they biopsy the tumor, and it IS malignant, then they risk spreading the malignancy.
Fingers crossed that it stays at 4 mm and is determined to be benign. :-)
1. congrats on the cyst only!!
2. AFP is not reliable, never rely on it as it notoriously poor according to most recent articles and misses countless tumors.
3. you should be having an MRI regularly. Some docs will do an untrasound every 6 months, and then an MRI...so one of each each year...I agree with this because even gandolinium used in MRI's can pose problems...however, ultrasound is not as good at finding tumors, so if I had a high AFP level, it would make more sense to screen every six months with MRI...reason is, you only have a short window, 3 months or so, between the time a tumor begins and the time it needs to come out. Malignant tumors in the liver spread fast...ergo the best screen, at LEAST every 6 months would be optimum
4.your doc should have been giving you MRI's, then they would have known it was a cyst without needing to do a CT...doing the CT to follow up the questionable area was definite but not as safe for you. Since most masses are benign, most a cysts, he could have saved you that exposure.
CT should be the LAST resort as it gives you literally hundreds of x-ray exposures, the last thing a sick liver needs. That much radiation causes thousands of free radicals to form, and if the immune system cannot keep up and destroy all of them, then it will lead to seedlings of new tumors. Maybe your body can catch up and get rid of them all, but maybe not...so why take that chance?
Make sure therefore that you insist on the least harmful type scans going forward. Doing the MRI first might have cost more long term, as had it left doubt a CT would have needed to be ordered anyway...but the patient would be better served by not having the exposures, so I'd have ordered an MRI first.The amount of xrays given in one CT scan are sufficient to cause tumor formation so looking for tumors with a machine that is known to cause them is hardly optimum.
mb
2. AFP is not reliable, never rely on it as it notoriously poor according to most recent articles and misses countless tumors.
3. you should be having an MRI regularly. Some docs will do an untrasound every 6 months, and then an MRI...so one of each each year...I agree with this because even gandolinium used in MRI's can pose problems...however, ultrasound is not as good at finding tumors, so if I had a high AFP level, it would make more sense to screen every six months with MRI...reason is, you only have a short window, 3 months or so, between the time a tumor begins and the time it needs to come out. Malignant tumors in the liver spread fast...ergo the best screen, at LEAST every 6 months would be optimum
4.your doc should have been giving you MRI's, then they would have known it was a cyst without needing to do a CT...doing the CT to follow up the questionable area was definite but not as safe for you. Since most masses are benign, most a cysts, he could have saved you that exposure.
CT should be the LAST resort as it gives you literally hundreds of x-ray exposures, the last thing a sick liver needs. That much radiation causes thousands of free radicals to form, and if the immune system cannot keep up and destroy all of them, then it will lead to seedlings of new tumors. Maybe your body can catch up and get rid of them all, but maybe not...so why take that chance?
Make sure therefore that you insist on the least harmful type scans going forward. Doing the MRI first might have cost more long term, as had it left doubt a CT would have needed to be ordered anyway...but the patient would be better served by not having the exposures, so I'd have ordered an MRI first.The amount of xrays given in one CT scan are sufficient to cause tumor formation so looking for tumors with a machine that is known to cause them is hardly optimum.
mb
So glad that it was nothing of concern... what sweet relief it is! Gongrats on the good news.
The MRI showed that it's just a liver cyst...will follow up in 2 months with another AFP bloodwork...I'm so relieved!
Okay, phew, the paper results came in the mail today, indicating it looks like a cyst, but my AFP requires an MRI. I saw my dr today, for a lingering virus (unrelated to this) & talked about the MRI a bit, so I'm pretty relieved! Still, I'll be more relieved after Saturday's MRI!!
HCC is usually found in the setting of cirrhosis, so it would be unusual for your lesion to be a malignancy if you don't have cirrhosis. Even in healthy livers it's not unusual to see benign lesions -- hemangiomas and cysts being the most common lesions. Ultrasound does not have much utility in distinguishing lesion characteristics, so hopefully the MRI will give you reassurance that it is nothing malignant. Hopefully you won't need to concern yourself with liver cancer, but even if it IS worst case scenario, early detection of HCC in recent years has greatly increased the long-term survival. Wishing you a good outcome. ~eureka
American Association for the Study of Liver Disease (AASLD) is a group of scientists and healthcare professionals who focus is preventing and curing liver disease.
This article will give you all the lastest information about HCC. It's risk, surveillance, diagnosis, and treatment.
From page 4 of the AASLD's latest practice guidelines (2010) on HCC.
http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/HCCUpdate2010.pdf
...
Hepatitis C
"The risk of HCC in patients with chronic hepatitis C is highest among patients who have established cirrhosis,where the incidence of HCC is between 2%-8% per year.
It should be noted that these data come from clinic-based studies. There is a single prospective population-based study of the risk of HCC in patients with hepatitis C. In this study of 12,008 men, the presence of anti-HCV-positivity conferred a 20-fold increased risk of HCC compared to anti-HCV negative subjects. The presence or absence of cirrhosis was not evaluated.
Hepatitis C infected individuals who do not have cirrhosis have a much lower risk of developing HCC." In the HALT C study, the 5-year risk of non-cirrhotics developing HCC was 4.8%."
Me again. Note: That it is recommended that only patient with an incidence of > 1.5% be monitored for HCC. Meaning that for persons without cirrhosis they normally wouldn't be monitored of HCC because the chance of having HCC is low, less than 1% per year.
Hopefully none of this will be relevant to you as it is determined you don't have HCC.
Hang in there!
Hectorsf
This article will give you all the lastest information about HCC. It's risk, surveillance, diagnosis, and treatment.
From page 4 of the AASLD's latest practice guidelines (2010) on HCC.
http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/HCCUpdate2010.pdf
...
Hepatitis C
"The risk of HCC in patients with chronic hepatitis C is highest among patients who have established cirrhosis,where the incidence of HCC is between 2%-8% per year.
It should be noted that these data come from clinic-based studies. There is a single prospective population-based study of the risk of HCC in patients with hepatitis C. In this study of 12,008 men, the presence of anti-HCV-positivity conferred a 20-fold increased risk of HCC compared to anti-HCV negative subjects. The presence or absence of cirrhosis was not evaluated.
Hepatitis C infected individuals who do not have cirrhosis have a much lower risk of developing HCC." In the HALT C study, the 5-year risk of non-cirrhotics developing HCC was 4.8%."
Me again. Note: That it is recommended that only patient with an incidence of > 1.5% be monitored for HCC. Meaning that for persons without cirrhosis they normally wouldn't be monitored of HCC because the chance of having HCC is low, less than 1% per year.
Hopefully none of this will be relevant to you as it is determined you don't have HCC.
Hang in there!
Hectorsf
Hi, thanks for the responses! No, I don't have cirrhosis (that I know of); I was diagnosed with Hep C 4 yrs ago during what I believe to be the acute stage of infection.
My PCP measures my AFP 2x a year; it goes up & down, never lower than 10, never higher than 21 (where it's at now), but it's been all over the place within those parameters.
I had an ultrasound 8 months ago which showed no tumors; not sure if this was there at the time but didn't show up due to the sensitivity of the test, or if it's a new mass. I hope it's benign but only got the CT results today & haven't had a chance to talk to my dr. directly or to really wrap my head around it. Arrgh!! Bad start to a 3-day weekend!!
My PCP measures my AFP 2x a year; it goes up & down, never lower than 10, never higher than 21 (where it's at now), but it's been all over the place within those parameters.
I had an ultrasound 8 months ago which showed no tumors; not sure if this was there at the time but didn't show up due to the sensitivity of the test, or if it's a new mass. I hope it's benign but only got the CT results today & haven't had a chance to talk to my dr. directly or to really wrap my head around it. Arrgh!! Bad start to a 3-day weekend!!
As Trin posted above it is not uncommon to have a benign mass so please try to console yourself with that information. You don't mention whether you have cirrhosis or not? HCC is much more common in patients with cirrhosis then in other persons who don't have cirrhosis.
As was mentioned, it is not uncommon to have an elevated AFP level with HCV. It is more common that your AFP would continue over a period of time to rise in the hundreds of units or to be above 500 as indicative of HCC. Also remember that AFP is not an accurate indicator of HCC. If my memory serves me, it is about 60% accurate. Meaning some people with HCC have no rise in AFP, while other with elevated AFP levels may not have HCC. My own AFP levels have varied around 100 ng/ml for the last year and a half.
I hope you are okay and don't have HCC. I am glad they are looking into it which shows the you are being looked after properly.
Hang in there. Let us know what happens.
Best-
Hectorsf
As was mentioned, it is not uncommon to have an elevated AFP level with HCV. It is more common that your AFP would continue over a period of time to rise in the hundreds of units or to be above 500 as indicative of HCC. Also remember that AFP is not an accurate indicator of HCC. If my memory serves me, it is about 60% accurate. Meaning some people with HCC have no rise in AFP, while other with elevated AFP levels may not have HCC. My own AFP levels have varied around 100 ng/ml for the last year and a half.
I hope you are okay and don't have HCC. I am glad they are looking into it which shows the you are being looked after properly.
Hang in there. Let us know what happens.
Best-
Hectorsf
I thought if you had HCC that your AFP would likely be way up like 500+ 9-12 is only slightly elevated right?
I've seen people report they were diagnosed with a liver hemangioma which is a noncancerous (benign) mass that occurs in the liver. A liver hemangioma is made up of a tangle of blood vessels. Liver hemangioma is sometimes called hepatic hemangioma or cavernous hemangioma. Did your doctor mention this?
It is not unual for those with hepc to have an elevated AFP.
Trinity
It is not unual for those with hepc to have an elevated AFP.
Trinity
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