I have had cysts or they use the term mass for years. One is just a Nass of blood vessels I think. They were unchanged as of 2022. Never knew they were there, found when other tests done. Blood work was fine and I was told there's no reason to worry.
But how long do you leave them in between checking? Think one 6cm and others 2 cm. I may just be prone to them. They could have been there for 20 years for all I know. But now I know and wonder if you should have an MRI every few years.
Thanks
Hi. I honestly didn't have any experience or knowledge of cysts in the liver so I did a little reading. From what I gather they are usually benign and not a problem BUT a small percentage can be a problem. I think the one that's 6 cm would worry me. Have you seen a liver specialist about them? If it was me, I think I'd try to get into a liver specialist and ask about them. I say this mainly because my late husband should have been screened due to risk factors for HCC and no one told us. So because of that experience I'd rather be safe than sorry and discuss the risks and whether it needs to be monitored with a specialist. Hopefully someone else has more knowledge about the subject and can offer their opinion. Sharon ❤️
### Follow-up Recommendations for Long-standing Cysts/Masses (Including Suspected Hemangioma)
---
### **I. Benign Characteristics of Your Condition**
1. **Stability**:
- No changes observed since 2022, with possible existence for up to 20 years, suggesting slow growth (a hallmark of benign lesions).
2. **Asymptomatic Nature**:
- Absence of pain, pressure symptoms, or abnormal blood work supports benignity.
3. **Initial Clinical Assessment**:
- Your physician’s reassurance ("no reason to worry") aligns with the lack of high-risk features (e.g., irregular borders, abnormal vascularity).
---
### **II. Imaging Surveillance Guidelines**
#### **(A) Monitoring Frequency**
- **6 cm mass**:
- **Every 12–18 months** (MRI or ultrasound).
- *Rationale*: Masses >5 cm carry a slightly higher (though still low) risk of complications, even if stable.
- **2 cm masses**:
- **Every 2–3 years**, unless located in high-risk areas (e.g., liver edge, brain).
#### **(B) Imaging Modality Options**
| **Modality** | **Best For** | **Pros** | **Cons** |
|--------------|----------------------------|------------------------------------|------------------------------------|
| **Ultrasound** | Superficial/abdominal masses | No radiation, low cost | Operator-dependent accuracy |
| **MRI** | Deep/complex structures | No radiation, superior soft-tissue resolution | Expensive, longer scan time |
| **CT** | Emergency evaluation | Fast, widely available | Radiation exposure |
*Recommendation*:
- Prioritize **MRI** for the 6 cm mass (ideal for long-term tracking).
- For smaller masses (2 cm), consider alternating between MRI and ultrasound to reduce costs.
---
### **III. Red Flags Requiring Immediate Re-evaluation**
1. **Growth**:
- >0.5 cm/year increase in the 6 cm mass, or sudden growth in smaller masses.
2. **Morphological Changes**:
- Irregular borders, new solid components, or heterogeneous enhancement.
3. **New Symptoms**:
- Pain, skin discoloration, fever, or signs of obstruction (e.g., jaundice, bowel issues).
---
### **IV. Special Considerations for Hemangiomas**
If the 6 cm mass is confirmed as a **cavernous hemangioma**:
- **Rupture Risk**: <3% lifetime risk (higher if subcapsular in the liver or with trauma).
- **Medication Adjustments**:
- Avoid anticoagulants/antiplatelets if possible; inform doctors about the mass before surgeries.
- **Pregnancy**:
- Estrogen may promote growth; discuss pre-pregnancy imaging with a hepatologist (if liver-based).
---
### **V. Practical Steps**
1. **Imaging Archive**:
- Save DICOM files from each scan for precise comparison over time.
2. **Consistent Imaging Protocol**:
- Use the same hospital/scanner for follow-ups to minimize variability.
3. **Lifestyle Adjustments**:
- Avoid repetitive trauma to the mass area (e.g., contact sports if liver-based).
4. **Genetic Counseling**:
- Recommended if family history suggests hereditary vascular anomalies (e.g., HHT).
---
### **VI. Cost-Saving Strategies**
- **Insurance Coverage**: Request inclusion of surveillance imaging under "chronic condition management."
- **Clinical Trials**: Explore observational studies (e.g., "hemangioma natural history") for free monitoring.
- **Modality Mix**: Use ultrasound for 2 cm masses and reserve MRI for the 6 cm lesion.
---
### **Proposed Follow-up Plan**
1. **6 cm mass**:
- **MRI + contrast-enhanced ultrasound every 18 months**.
2. **2 cm masses**:
- **Ultrasound every 3 years**.
3. **Annual Labs**:
- Platelet count, liver function (AST/ALT), and coagulation profile.
---
### **Key Notes**
- Check your 2022 imaging reports for **LI-RADS** (liver) or **BI-RADS** (breast) classifications, which clarify risk stratification.
- Share this plan with your primary care physician or a relevant specialist (e.g., hepatologist, radiologist) for personalized adjustments.
Benign masses rarely require intervention, but structured surveillance ensures early action if atypical changes arise. Stay proactive, but avoid over-monitoring—your current stability is reassuring! 🌟
My mom has HCC
Experience with rising AFP but stable scans?
