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Navigating the Discovery of a Hepatic Hemangioma: Next Steps

7/11/2025, 1:50:29 PMMale25-34

Recently, I underwent an MRI to investigate persistent discomfort in my upper right back, which unexpectedly revealed a lesion, prompting a follow-up ultrasound. The subsequent examinations, including both a contrast and non-contrast MRI, yielded the following findings: 1. A benign hepatic lesion, most likely a hemangioma located in segment VI of the right lobe of the liver, measuring approximately 3.7x4.1x4.2 cm. 2. Simple renal cortical cysts observed bilaterally, with the largest measuring 1.0 cm in my right kidney. 3. No other notable abnormalities detected. To my surprise, my liver-related blood tests came back normal, adding to the shock of this unexpected diagnosis. Physicians repeatedly inquired about any symptoms I might be experiencing. However, honestly, I'm uncertain. I've dealt with chronic fatigue and have previously been diagnosed with fibromyalgia; moreover, my back pain could be attributed to a pinched nerve. Given the size of the hemangioma, I’m left wondering if removal is warranted or if I should simply monitor its growth. My primary care physician suggested we reassess everything in six months to track any changes, which leaves me questioning whether this lesion could be the cause of many of my ongoing health issues rather than what I previously believed. Additionally, I wanted to mention that I had a gallbladder ultrasound conducted 2.5 years ago, initiated by my gastroenterologist due to some irritation linked to my existing Erosive Gastritis. In the report from April 2023, it clearly indicated that I had no abnormalities, masses, or cysts in the liver. Shouldn't a hemangioma of this size have been detectable back then? Is it possible it developed rapidly since then? My primary care doctor found the situation perplexing and speculated that it might have been overlooked due to the primary focus on my gallbladder. The imaging angle could also have affected the visibility of the lesion. From my understanding, this hemangioma is situated on the lower right side of my liver. What are your thoughts? Would consulting with a hepatologist or a surgeon be a prudent next step? I am feeling quite overwhelmed and uncertain following this unexpected turn of events.

LupusFibromyalgiaInternal Medicine

Answers (1)

Cony

7/11/2025, 1:50:46 PM

OpenHealth AI

It's understandable to feel overwhelmed after receiving unexpected news about a hepatic hemangioma. Let's break this down to clarify your situation and explore your next steps.

Key Points:

  1. A hepatic hemangioma is usually a benign (non-cancerous) vascular tumor of the liver and often does not require any intervention.
  2. Your recent imaging suggests monitoring over immediate intervention, especially given your lack of symptoms.
  3. It's natural to have concerns about whether this lesion relates to your ongoing health issues, especially with your chronic fatigue and fibromyalgia.

Explanation:

  1. Hepatic Hemangioma: This lesion, being benign, often doesn’t cause symptoms unless significantly large or causing pressure on adjacent structures. Your normal liver function tests are reassuring, indicating that the liver is functioning adequately.

  2. Monitoring vs. Surgery: Your primary care physician's recommendation for a follow-up in six months to reassess the hemangioma is typical. Many small hemangiomas require no treatment since they are stable and often go unnoticed for years.

  3. Development Questions: It’s possible for hemangiomas to grow slowly or remain stable over time. They sometimes are not detected in earlier imaging due to factors like the angle of the ultrasound or the focus of the examination.

Next Steps:

  1. Follow the Monitoring Plan: Continue with the recommended ultrasound and follow-up in six months. Keep a log of any new symptoms you may notice in the meantime.

  2. Symptom Journal: Given your history of chronic fatigue and fibromyalgia, documenting any changes in your symptoms (e.g., fatigue levels, back discomfort) can provide valuable information for your healthcare provider.

  3. Consultation Consideration: If you feel extremely anxious about the hemangioma or if new symptoms arise, consider requesting a consultation with a hepatologist. They can provide specialized insights and reassurance regarding your liver health.

  4. Focus on Comprehensive Health: In parallel, it may be beneficial to manage your fibromyalgia and any other chronic conditions through your regular healthcare team, addressing fatigue and pain management comprehensively.

  5. Emotional Support: Understandably, this diagnosis can be distressing. If you're feeling overwhelmed, talking to a counselor or joining a support group for individuals with similar conditions could be helpful.

Conclusion:

You're taking the right steps by seeking more information and planning for follow-ups. Remember, most hemangiomas do not develop complications, and with proper monitoring, you're likely to be well. Please keep communicating with your healthcare team, and don't hesitate to ask any further questions or express concerns about your health. You're not alone in navigating this!

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