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Hepatic mass Yekaterina Rabkin 7/22/05.

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Presentation on theme: "Hepatic mass Yekaterina Rabkin 7/22/05."— Presentation transcript:

1 Hepatic mass Yekaterina Rabkin 7/22/05

2 39yo woman had RLQ pain in Febraury
Long-term use of oral contraceptives CT showed 4.7 x 6.9 x 7cm enhancing lesion in the right lower lobe of the liver, also a 15 x11 mm lesion in the left lobe LFTs normal AFP=2.7 (0-9.0), CEA=0.8 (<5.0)

3 Differential diagnosis of a hepatic mass
Hemangioma – most frequently identified hepatic mass, may need resection if large Metastasis – most common neoplasm in the liver, bad prognosis Focal nodular hyperplasia Most common benign hepatic tumor Usually asymptomatic, may have pain if hemorrhages Central fibrous scar with fibrous septae characteristic

4 Differential diagnosis of a hepatic mass
Hepatocellular carcinoma Usually associated with cirrhosis Alpha-fetoprotein is the most common laboratory abnormality, elevated in 70-90% Resection is usual treatment, but prognosis is poor Other malignant lesions Fibrolamellar carcinoma – younger, no cirrhosis Hepatoblastoma – infants Angiosarcoma – industrial exposure Cholangiocarcinoma – biliary disease

5 Differential diagnosis of a hepatic mass
Hepatocellular adenoma Associated with oral contraceptives LFTs usually normal Complications include hemorrhage Usually require resection Other benign lesions Nodular regenerative hyperplasia Hepatic cyst Biliary cystadenoma



8 Pt stopped oral contraceptives and came in for a repeat CT June 27
The masses are minimally decreased in size Patient is going to follow up with surgery for resection and biopsy of the mass

9 Source Douglas R. LaBrecque, MD
Mass Lesions & Neoplasia of the Liver - CURRENT DIAGNOSIS & TREATMENT IN GASTROENTEROLOGY - 2nd Ed. (2003) » Section VI. Diseases of the Liver & Biliary System

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