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Weight Loss, Blonde Stools And Weakness. Can Lesion On Liver Cause These Symptoms?

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Posted on Fri, 25 Oct 2013
Question: Well I'm back again. I wrote to you about my cholangiocarcinoma that I had 7 years ago and am now having symptoms of weight loss, blonde stools, weakness and general not feeling well at all. I had an MRI and they say it is fine but now have another "lesion" on my liver, another one since 20 months ago, but that it is a hemangioma. They say it is "incidental" the last time the radiologists said it was a hemangioma too even when it was16 cm x can't remember the rest of the dimensions.It was so big that when I laid on my back I could move it around. My question is if these are small lesions, 1 cm. can they cause these symptoms? XXXXXXX
doctor
Answered by Dr. Dr. Ivan Romich (1 hour later)
Brief Answer:
Hi and welcome to XXXXXXX

Detailed Answer:
Well,generally no,1cm liver lesions,especially hemangiomas cant cause any symptoms unless it is located in place where it can obstruct main biliary duct,but this is very rare so I dont think this is a reasonf for your symptoms.
Hemangiomas are usually (but not always) pretty well differentiated from carcinomas and metastatic tumors by radiologic appearance so if there is pattern of hemangioma on CT then the chance of being something else is very low(also in 20 months any liver malignancy would progress rapidly). However it can never be 100% for sure so in people with previous history of carcinomas,it is always recommended to do PET SCAN,not regular CT scan as it is more sensitive for liver lesions and will show even 0.5cm suspect lesions.
Hemangiomas can grow even more than 25cm so 16cm is not something unusual. Problems may occur if it rupture or press surrounding tissue and organs(but this risk would be seen on CT scan). There is no need for surgical treatment if hemangioma dont cause any symptom.
All you need at this point is frequent ultrasound check of size of these lesions.
Your symptoms are probably caused by inadequate liver function(If there is fatty live,liver fibrosis or insufficient bile secretion then it may lead to your condition) or bowel motility disorder. it should be treated by dietary changes,but also,gastroenterologic work up with endoscopy should be done.

Wish you good health. Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ivan Romich (26 minutes later)
the large "lesion I talked about was not a hemangioma, it was cancer but the docs including radiologist SAID hemangioma when it in fact it was cancer. I am set up to see a GI specialist.
doctor
Answered by Dr. Dr. Ivan Romich (2 hours later)
Brief Answer:
Hi

Detailed Answer:
Well, if this was 16 cm large cancer then you are really luck that there is no sign of relaps on mri. This is not usual mistake of doctors and it should have been resected in much earlier phase,but now it is most important that there is no sign of recurence.
However, these new lesion must be carefully followed up by ultrasound in next several months and if there is size progression then biopsy or PET scan should be done.
Blonde stools are caused by bilirubin secretion disorder and it leads to weight loss and fatigue. So check your liver tests and bilirubin levels. If this is fine then your problems are probably caused by bowel issue such as ibd, inflammatory bowel diseases or food allergies so these are first things to rule out.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Ivan Romich

General Surgeon

Practicing since :2008

Answered : 13888 Questions

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Weight Loss, Blonde Stools And Weakness. Can Lesion On Liver Cause These Symptoms?

Brief Answer:
Hi and welcome to XXXXXXX

Detailed Answer:
Well,generally no,1cm liver lesions,especially hemangiomas cant cause any symptoms unless it is located in place where it can obstruct main biliary duct,but this is very rare so I dont think this is a reasonf for your symptoms.
Hemangiomas are usually (but not always) pretty well differentiated from carcinomas and metastatic tumors by radiologic appearance so if there is pattern of hemangioma on CT then the chance of being something else is very low(also in 20 months any liver malignancy would progress rapidly). However it can never be 100% for sure so in people with previous history of carcinomas,it is always recommended to do PET SCAN,not regular CT scan as it is more sensitive for liver lesions and will show even 0.5cm suspect lesions.
Hemangiomas can grow even more than 25cm so 16cm is not something unusual. Problems may occur if it rupture or press surrounding tissue and organs(but this risk would be seen on CT scan). There is no need for surgical treatment if hemangioma dont cause any symptom.
All you need at this point is frequent ultrasound check of size of these lesions.
Your symptoms are probably caused by inadequate liver function(If there is fatty live,liver fibrosis or insufficient bile secretion then it may lead to your condition) or bowel motility disorder. it should be treated by dietary changes,but also,gastroenterologic work up with endoscopy should be done.

Wish you good health. Regards