Patient's Query
Hi doctor,
My father is 56 years old. He is a diabetic patient. He has a frequent low-grade fever associated with pain in the right side of the front abdomen, starting just below the lungs. He also had significant weight loss in the past two months. He has also developed a breathing issue suddenly while talking, and gets tired easily after performing minimal tasks. He was recently admitted to a hospital where he underwent all the necessary tests and the USG of the whole abdomen, which reported a SOL of size 42 × 35 mm in the right upper lobe of the liver and no other complexities.
Further, he has taken a CECT scan where the report came as mild pleural thickening and minimal effusion seen on the right posterior costal wall of lower thorax and a SOL of size 3.9 × 3.5 × 4.3 inches which is hypodense in nature having a rim and a centripetal enhancement seen in right lobe of liver devoid of calcification or cystic or necrotic degeneration in the right lobe and the radiologist commented as the nature of the SOL suggestive of hemangioma. He has undergone an AFP (alpha-fetoprotein) test, which gave a reading of 1.28 ng/mL. Also, he had a serum ferritin reading of 864.5 ng/mL. He has also undergone a colonoscopy due to occult blood in stool and was found to be alright. He is discharged from the hospital with some medication. Please guide me with the further procedures, as he is still facing issues with his health.
Kindly guide.
Hi,
Welcome to icliniq.com.
Sorry to hear about your father's symptoms. I have checked the attached photos thoroughly (attachment removed to protect patient identity). I agree that his symptoms are due to a SOL (space-occupying lesion) in the liver, which is most likely a hemangioma. I will reassure you that the lesion is not malignant. However, a ruptured hemangioma is a severe condition. In most cases, there is conservative therapy for treating the symptoms. It is followed by repeating the ultrasound after one month, three months, and then every six months to identify any increase in size.
Usually, lesions less than 2.3 inches are treated conservatively. Surgery is the treatment for lesions more than 2.3 inches, rapidly growing lesions, ruptured hemangioma, or severe, uncontrolled symptoms. I recommend Paracetamol for the pain and fever. Please send me the CBC (complete blood count) report to exclude the ongoing infection.
I hope this helps.
Kindly follow up if you have more concerns.
Thank you.
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Answered byDr. Mahmoud Ahmed Abdelrahman Abouibrahim
Medically reviewed byiCliniq medical review team
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