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Ultrasonographic evaluation shows enlarged liver with inhomogeneous parenchyma. What are the findings from the report? Suggest remedy?

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General & Family Physician
Practicing since : 2009
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Hi my father ultrasonografic evaluation shows enlarged liver with inhomogenous parenchyma 8.7*8.2 echogenic mass... could you please suggest about the remedy.

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Posted Thu, 3 Oct 2013 in Liver and Gall Bladder
Answered by Dr. Shoaib Khan 56 minutes later
Brief Answer:
Cancer of liver suspected,treatment options listed

Detailed Answer:
Hello and welcome.

Thank you for writing in.

I am sorry to inform you about the same, but I would have to rightfully start by explaining the suspected diagnosis, based on the ultrasonographic examination. A hepatoma is suspected, although not confirmed. A hepatoma is also called hepatocellular carcinoma; which is a primary malignancy/cancer of the liver. Also suspected is spread of the cancer within the liver; and resulting in collection of fluid as well.

To start off, we will have to first confirm the diagnosis with the help of a triple phase CT scan or an MRI is found to be very helpful in making an accurate diagnosis and also in staging the cancer (if it is indeed cancer). Once the diagnosis is confirmed, we should move on to treatment options, which is your main query, they include:
-TACE (transcatheter artery chemoembolization): Delivery of high dose chemotherapy into the artery which supplies the cancer (drugs like doxorubicin, cisplatin, or mitomycin C)
-Other chemotherapeutic agents with less successful results (eg. sorafenib, tamoxifen, antiandrogens, interleukins, octretide, etc.)
-Radiotherapy (dose of 150 Gray)
-Surgical resection of only the cancer: Is possible only if the tumor is 5 cm in size or less; and in the absence of liver cirrhosis; in your father's case, there is no cirrhosis from the report, but the tumor is quite large
-Liver transplantation: This is the last option, and is usually not very successful; as is advised for patients whose cancer has spread to almost the entire liver; and without a transplantation, there is a slim chance of survival. But there is a high risk of rejection of the new liver (difficult to find a donor which will complement the patient); and finally, even if the patient's body does accept the liver, the cancer would have been in its late/terminal stages and would have spread to other organs as well, ultimately resulting in cancer in other parts as well.

I am sorry to inform you all this. But please, do discuss all the pros and cons of the treatment options, and choose only the best options for your father. It is best to involve a surgical oncologist and initiate treatment at the earliest. Please feel free to write back to me for any further clarifications.

Wishing you father all the luck he needs. God bless.
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