Liver mass!

Chief Complaint A 52-year-old female complains of diffuse abdominal pain, which was relieved on analgesia. She complained of obstructed defecation for the past 3 months. History No nausea, vomiting, loss of appetite or weight loss. No other past medical history. Examination Physical examination is within normal limits. No splenomegaly or palpable liver noted. Investigations Hb: 12.5 g/dl and a CRP: 6.5 mg/dl (reference range <0.5 mg/dl). Carcinoembryonic antigen level was also check which shows normal limits <0.2 ng/ml; (reference range 0–5ng/ml). X-ray wnl. USG of the abdomen shows a 15 × 16 cm semisolid tumor mass in the right lobe of liver. CT shows a tumor mass with necrosis. Diagnosis What is your opinion? What next should be done?

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Large tumor mass in liver The very fact that carcinoembryonic antigen level is done, the physician is thinking of malignancy No doubt, malignancy is first differential diagnosis ? Hepatocellular carcinoma ? Intrahepatic cholangiocarcinoma Adv Alfa feto protein Biopsy Histopathology Treatment based on reports

Hepato - cellular carcinoma is the most likely Diagnosis. An urgent Alfa - feto protein estimation is indicated A PET scan is indicated to confirm the diagnosis and look for any distant metastasis A CT guided biopsy is indicated before starting any treatment but Correct PTI before biopsy. If no distant metastasis are evident - a right hepatectomy is indicated


Suggest Alfa fetoprotein estimation PETCT to check metabolic activity and metastasis. CT guided biopsy of the liver mass. Partial heoatectomy

Thank you ,Dr Amith Gupta

Mahashankh Vati Agnitundi Vati Livoplan Syrup Heartburn Capsules

Surgical resection

A colonoscopy also if the primary is in the colon

Hepatoma, requires partial hepatectomy

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