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Dr. Ravoof
Dr. Ravoof, Doctor
Category: Medical
Satisfied Customers: 2657
Experience:  Experienced Physician in the field of Medicine and Surgery.
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Wat is a new liver lesion?

Customer Question

Wat is a new liver lesion?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

Thanks for your question.

In what context did you read or hear this phrase? Please also inform about any relevant history.

Thanks.
Customer: replied 2 years ago.

Ok. Well my dad had cc surgery in march .he was stage 3 with no spread. Recent ct scan in april was clear . However cea rose as-

may - 3

june - 4

july -6

august - 8

so a ct scan was done 2 weeks ago which showed a 15 mm lesion in liver ?

Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

Thanks for your reply.

Basically an increases in test values of CEA over time in a patient with a history of cancer suggest tumor recurrence. But serum CEA must be interpreted in conjunction with information from the clinical evaluation and other diagnostic procedures. Hence at present I would suggest a needle biopsy of the liver lesion which has newly occured and was not present before, to diagnose the cause of the new liver lesion.

Take care.
Customer: replied 2 years ago.

So could this be a liver met then plus with a cea of 8?

Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

Thanks for your reply.

Yes that could be one of the possibilities which your doctor and the pathologist doing the microscopic study of the needle biopsy would consider. However a biopsy is required to either confirm or deny our suspicions.

Take care.
Customer: replied 2 years ago.

They have ordered a pet scan why is

that then.

Is a cea of 8 regarded high ?

Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

As I said the serum CEA must be interpreted in conjunction with information from the clinical evaluation and other diagnostic procedures. So the doctors have ordered a PET scan since a PET scan will be beneficial and cancer cells will show up as bright spots on PET scans since they have a higher metabolic rate than normal cells. Therefore PET scans may be useful for revealing whether cancer has spread and for finding a cancer recurrence.

Regarding CEA the normal reference value is in nonsmokers is less than or equal to 3.0 ng/mL. So CEA of 8 is considered high. However more than the single value changes assessed over time are informative. And as I said an increases in test values of CEA over time in a patient with a history of cancer suggest tumor recurrence.

Take care.
Customer: replied 2 years ago.

He has a history of liver cysts but this is not liekly

to be a new cyst that has occurred right ?

Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

Thanks for your reply.

Yes in view of the previous history this is more likely not a new benign cystic lesion. However the PET scan will throw more light and if not conclusive then needle biopsy will be the next step.

Take care.
Customer: replied 2 years ago.

Could it be a hemiginoma?

Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

That is another possibility which the doctors would consider. However only further tests done will correctly diagnose the lesion.

Take care.
Customer: replied 2 years ago.

The onco exact words were ... We are not sure as it looks cloudy so need to do a pet . What can this cloudy be. ?

but on the report the radiologist said 1 new lesion .... Appearances keeping with disease progression .It seems the radiologist is sure right ?

Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

Thanks for your reply.

Yes based on their words, and further advice and actions it seems that they are suspecting metastatic carcinoma in the liver.

Take care.
Customer: replied 2 years ago.

If they are suspecting a liver met then would the onco say im

not sure ?

Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

Even after a PET scan there are many cases where a doctor is still not sure, hence a biopsy is confirmatory. Therefore without any confirmation a doctor can never be sure and that is what he/she would say.

Take care.
Customer: replied 2 years ago.

Ok but would a ct give a good idea of it being a met?also what can this mean ... It is cloudy ?

Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

Thanks for your reply.

I am happy to give you excellent service, but you have not accepted any of my answers on any of the questions.

If you want to continue, you need to accept my other answers.

Take care.
Dr. Ravoof, Doctor
Category: Medical
Satisfied Customers: 2657
Experience: Experienced Physician in the field of Medicine and Surgery.
Dr. Ravoof and 2 other Medical Specialists are ready to help you
Customer: replied 2 years ago.

What can they mean by the terms it's cloudy?

Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

Thanks for your reply.

This is a very subjective non-standard term and probably they meant that the opacity was hazy. However the use of this term does not point to any specific diagnosis.

Take care.
Customer: replied 2 years ago.

I think that too . But how come the radiologist was sure to


put such comment like appearancea keeping with disease progression ?

Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

Every disease has a certain appearance radiologically and the radiologist studying the scan has given his impression. However this would not be considered diagnostic and further studies are needed to accurately diagnose the cause.

Take care.
Customer: replied 2 years ago.

Are the radiologists usually right ? Also once this met got rid off could this b the end of it?

Expert:  Dr. Ravoof replied 2 years ago.
Dear customer,

Yes the radiologists are usually right. Regarding prognosis this has to be individualized with a personal treatment plan. We cannot say with certainty that this is the end of it. Sorry.

Take care.

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