Hello and thanks for the query.

From the information you provided, it sounds like your physicians are following you appropriately. I would very much appreciated if you could forward me a copy of the biopsy results in order for me to review the actual findings. You may send that to my attention at YYYY@YYYY . This would help me immensely in considering your question.

I am not very concerned at all about this very minor increase in the alkaline phosphatase. A few things can contribute to this - among them is 1) a slight obstruction of normal bile flow in the liver 2) normal activity of cells in the bone or 3) pregnancy.

In your case I suspect what they are following is either a benign liver cyst or nodule. Another possibility would be a benign hemangioma. I am glad to hear that the imaging findings have not changed much as this bodes well and supports a very likely benign process.


I thank you again for submitting your query. I will look forward to additional information which you might be able to provide regarding the biopsy findings. When I receive those I will make further comments in reference to your question.

Sincerely,

Dr. Galamaga

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Hi XXXXXXX

Thanks again,

I reviewed the reports from the CT scans and MRI. I agree they see a soft tissue density in the liver. What is reassuring right now is that the size is stable. It has not grown, changed in size or shape and has not invaded any surrounding tissue.

It would be nice to have the biopsy report but as you say they found normal liver tissue. Assuming they sampled the correct part of the liver this is again reassuring.

One additional test which may be of utility in your case would be a PET scan. PET scans light up in areas where there is increased metabolic activity. If for example a PET was done and the area in your liver did not light up at all this again supports the likely diagnosis that this is a benign nodule.

In all likelihood this will have to be followed over time. Your docs may advocate another biopsy in the future if they feel it is necessary but in the setting of a stable nodule which is not getting bigger I think it is reasonable to watch closely.

I know this is a very concerning issue and assume you have alot of anxiety about it. I would like to reassure you, however that I think your docs are doing the right thing and acting appropriately given the imaging findings and the pathology report findings which you relayed to me.

Again I thank you for your query. I hope you have found our interaction to be helpful and informative. I am here for you if you have any additional concerns in the future.

Sincerely,

Dr. Galamaga

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