Multiple liver lesions

[hairbrain]

After on-going health problems this year I had a liver MRI which reported ‘at least 3 types of lesion’ present on my liver. A simple 4cm cyst, a 2.5cm haemangioma and a the third notable mass was reported as ‘most likely’ an ademona, 4.8cm involving the liver bed.

The GPs are totally writing me off when I attend with ongoing problems, despite one telling me he’d never seen one and to talk to a specialist I feel like I’m making a fuss when asking for a gastro referral. I attended recently with acute right rib pain which has now abated but ongoing indigestion and shoulder pain is constant. Have been suffering from colds/flu also for around 8wks. Was told rib pain was a pulled muscle and made to feel like a hypochondriac.

Took it up myself to talk the hospital gastro secretary myself and she relayed that the specialists don’t think the MRI results should be causing me pain either but she’ll try get me apmnt.

I had a private endoscopy a few wks ago, negative hplylori, no ulcers which was surprised me as I was sure it was this causing my never ending heartburn.

Should I be pursuing a gastro apmnt? There’s lots of info on the internet about liver adenomas, most suggesting that at very least they should be monitored - but no one seems to be even slightly concerned except me. I also am concerned at the ‘most likely’ diagnosis. I would be able to put this to the back of my mind if I felt well – but I don’t.

Appreciate any advice.

[Bolly]

Welcome coming over from patient access!

You might find this practice guideline interesting reading. Although it is American, I think it was published 2014. Bear in mind a guideline is just a guideline and doesn't have to be adhered to by doctors if they have differing views. For adenomas it recommends surgery for those greater than 5cm so yours is just under the size recommendation. But heck, if I was you i would not be arguing over .2 cm and would be pressing for a decision on whether to resect or not.

gi.org/wp-content/uploads/2...

Basically for the cysts and haemangioma the guideline is no intervention unless due to poor quality of life and for the adenomas intervention if over a certain size.

You should definitely have 6 monthly imaging to check on their possible spread/growth. For this you need your GP on board and in agreement and if it was me I would prefer to be under a hepatologist.

You could use the pain as a "quality of life" argument. However I can see their reluctance to discuss surgery, as it is not without risks and at the moment the risks may outweigh the possible benefit.

[hairbrain in reply to Bolly]

Hi Bolly !

Thanks again - yes I thought as much, that it should at least be monitored. I was just told to stop taking any oral contraceptives. But I haven't taken them in over 5yrs.

Feel like am making a fuss just to want to discuss it! I also wondered if the gallbladder involvement could be causing the back pain. The doctor eventually did a referral but said it's not a priority as 'it's not as if you have cancer or anything'.

I guess I have to press on & hope the gastro takes more of an interest..

x

[Mama41 in reply to hairbrain]

I had a 'benign' tumour removed from my liver a few years ago. The only symptoms I had were shoulder pain and indigestion.

After I had it removed it wasn't so benign after all. I'm not saying yours are cancerous but I wouldn't be happy just leaving them. At least they can give you scans every 6 months or so to ensure they aren't growing.

[hairbrain in reply to Mama41]

Thanks Mama, I have done much reading on the subject & have read that sadly it's not unusual for them to be wrong. I am just frustrated that they seem to be inferring that I'm making a fuss to even wish to discuss the findings!

Today I have what seems like my 56th version of the cold and am royally fed up. I guess I will be summoned to the gastro at some point but i don't see it being soon.

I hope you are well and your diagnosis hasn't turned your life completely upside down.

[Bolly in reply to hairbrain]

If you still have what you think is a cold, then it probably isnt. Viruses like coughs and colds are self limiting. What are the 'cold' symptoms you have had 56 times.

Remind me about your referral to a gastro (by the way, a hepatologist would be better for liver things, as a gastroenterologist deals with the oesophagus down to your back passage and all the digestive system in between, but doesnt specialise in the liver).

Was it your GP who said they were referring you, how long ago, and do you know to which hospital and which gastro by name? Just thinking about how you might find out where you are on the list without asking the GP who it seems is not forthcoming.

[hairbrain in reply to Bolly]

Hi Bolly,

I was exaggerating slightly re the colds

I came home from an overseas holiday with an ear infection, most likely just from swimming. This was very painful, lasted about 10 days then transformed into a cold, then a very chesty cough. That was 6wks ago, just as I think it's leaving the cold returns or i catch a new version. I still have the cough and a persistent sore throat & itchy bloodshot eyes. When I asked about it, the GP said i was just unlucky & no bacterial infection visible in throat..

I did actually talk to the NHS gastro secretary, who said the gastro and radiologist were happy with my MRI results which shouldn't be causing me pain. I don't understand exactly what she meant; they are happy the results are conclusive or they are happy the don't need to see me... However, I explained I am still suffering the problems which led to the MRI & she said she'd still get me an apmnt, which I'm waiting on. I am in the North of Scotland, I doubt we have a local hepatologist.

I guess I will wait til the end of the wk before being a nuisance & calling again. If I just had an apmnt in my calendar that i could aim for it would be easier. I know the gastro referrals up here are stretched and often take wks or months. She said she'd try get me an urgent one but it seems they don't feel it is urgent...

[Bolly in reply to hairbrain]

The persistent cough/cold thing is a puzzle. Do you mix with a lot of people who obviously have coughs and colds. I would have thought it highly unlikely that you would keep 'catching' repeated colds unless you are working day in day out with people who all have different colds. Are the symptoms perhaps sinusitis symptoms which would give you nasal stuffiness, sore throat, and cough, and fever? Just thrashing around here trying to think of other ideas. There was a TV campaign recently about if you had a cough for more than 3 weeks its not a virus its something else and should be checked out.

I'm not thinking the cough/cold/sore throat is connected to have liver cysts and adenomas, just that I cant believe they are virus coughs and colds as they should not last 6 weeks.

[hairbrain in reply to Bolly]

Small people.. I have 2 of them, one pre school and one high school! I guess it's likely regenerated bugs from the kids, and friends kids. I just feel really run down on top of the middle/upper pain and shoulder/back pain....

I try to exercise regularly & eat healthily. My BMI is 23 and I drink in moderation, mostly only at special occasions. I just want to feel fit & healthy again!

Patience is a virtue I guess!

[hairbrain]

Got a call this morning to say I have an apmt Monday with the gastroenterologist.

Am sure it's only due to my nagging. I will try to share my concerns & knowledge gathered without sounding like a neurotic loony hypochondriac...

Will update with any movement.

[Cibble]

Dear Hairbrain.

Please never feel you are a nuisance to the medical profession it is their job to confirm information and deliver it in a way you can understand and accept. Go to your appointment with a list of questions as you have here, include your worries about low immunity to colds etc.. tick them off & take time to document the answers ( better still take a note taker with you) as when you are in these consultations it can become a bit of a blur.

Hope all goes well.

Take care of you & yours

X Cibble

[hairbrain]

So I saw the gastro who kicked off by saying... your scans are 'not exciting' so what's up? (paraphrasing!). I went through the history all over again.... Eventually asked about the adenoma, can't it grow etc.. Long story short it seems everyone neglected to tell me that the consultants decided the initial radiologist report was wrong, and the adenoma is actually an a-typical haemangioma - so not an adenoma.

That's great & I have confidence in him.... but I am still in the same position i was back in June when I was seeing my GP for pain, worse in fact. He had a good prod of my stomach and believes the pain is lower than my liver. Asked for stool sample which he expects to be clear and will review my MRI results again to see if he can see what's below the liver. I had a specific liver MRI so if necessary he will order new scan.

I left feeling confident in him, although it struck me after that isn't the gallbladder below the liver? The contentious adenoma/haemangioma was noted as involving the gallbladder bed. Over the last week days the pain has moved firmly to the right side. Skin has started to itch mostly at night-time, no sign of yellowness but my eyes remain bloodshot every day.

I am relieved they are confident that there is no adenoma or anything else more sinister. But I would quite like to feel like myself once again & be rid of this pain. Patience for a bit linger it seems unless it miraculously resolves itself.