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Constipation, nervous stomach, mass in right liver lobe. Treatment?

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Practicing since : 2004
Answered : 1462 Questions
liver mass :

Hi doctor.
I am 32 years old.I have nervous stomach for almost 6 years.but for almost 8 months I am feeling a lump under right side of my stomach. It is palpable and it fluctuating in size. sometimes I cant feel the lump when I evacuate.

becuase I have constipation sympthom I went to doctor 4 times but all said its just nervous stomach and the stool stuck in my colon.

I finally asked my doctor to do an abdominal ultrasound and the result is

(((((Echogenic 1.2 cm solid mass in right liver lobe. the biliary system is not dilated. This is most likely represent a benign hemangioma.
If the patient has risk factors (underlying liver disease, known primary malignancy) then further characterization with CT is recommended. If no risk factors, then follow up ultrasound is advised in 6 month to ensure its stability.

The gallbladder, spleen , kidneys, pancreatic head and pancreatic body appear normal. the pancreatic tail is obscured by overlying bowel gas and cannot be assessed. There is no Ascites)))))

today doctor ordered blood test for hepetites and to check my liver and I did those test today.and Iam pretty sure I have no problem with my liver.I did an std test twice this year. including for hep c.

my questions are

1- How they can say the mass on my liver is benign , without doing an autopsy?(how reliable ultra sound is? )
2-DO you think should I do CT scan to make sure that is non cancerous?
3-If the mass is cancerous,what dose it mean? The mass is 1.2 cm , and I am not sure Its big or small.

thank you doctor,I am just little worried

Best regards.
Posted Sat, 5 May 2012 in Liver and Gall Bladder
Answered by Dr. Indranil Ghosh 3 hours later
Thanks for posting your query.

The lump on the right side of your stomach is probably hard stools impacted in colon. Probably you are having habitual constipation and that is giving rise to this problem. It is fluctuating in size and you cannot feel it after evacuating. Hence this clinches the diagnosis.

The liver lesion is of size 1.2 cm and it is certain that it is not that thing which you can feel. A 1.2 cm lesion embeded within the liver cannot be felt from above. Ultrasound is very useful to diagnose hemangiomas within the liver. Doing a biopsy for hemangioma is not recommended as it may lead to serious bleeding.

If your liver function tests and hepatitis markers are all normal then you do not need to go ahead with CT scan right away. You may wait it out for another 3-6 months till another ultrasound is repeated.

I don't think it is cancerous at all. Hence there is no reason to guess what it may be.

I hope, I have answered your query. Please accept my answer in case you have no follow up queries.

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