What Does This Abdominal Ultrasound Indicate?

Posted on Mon, 8 Sep 2014

Question: Hello Doctor:

My father is 62 years. We are from XXXXXXX His abdominal ultrasound has provided following details. Are these related to liver cancer in anyway?

Impression : Mixed echogenic mass in right lobe of liver in segments 7/8 with thrombosis of right
portal vein ? HCC / Metastatis.Thickened gall bladder wall - ? neoplastic.Grade-I
prostatomegalyTriple phase CECT of abdomen for further evaluation.Correlate clinically.

Observation : LIVER: Evidence of a large mixed echogenic mass lesion seen in right lobe of liver
measuring 8.0 x 7.0 cm showing vascularity in segment 7/8. Left lobe of liver is normal. Thrombosis
of right portal vein noted.COMMON BILE DUCT: Normal in size.GALL BLADDER: Partially
distended. Wall is thickened and measures 9 mm. No calculi.PANCREAS & SPLEEN: Normal in
size and echotexture.KIDNEYS: Right kidney measures: 99 x 36 mmLeft kidney measures: 97 x 40
mmBoth kidneys are normal in site, size and echotexture.No evidence of calculi /
hydronephrosis.URINARY BLADDER: Well distended with normal walls.No evidence of calculi /
growth / diverticula.PROSTATE: measures: 33 x 35 x 40 mm (Volume: 25 cc)Normal in size with
homogenous echogenicity.No evidence of calcification.Seminal vesicles are normal.OTHERS: No
evidence of any free fluid in pelvis.

Answered by Dr. Shoaib Khan (1 hour later)

Brief Answer:
Sadly it does confirm HCC

Detailed Answer:
Hello and welcome.

Thank you for writing to us.

I have gone through your query and ultrasound report with diligence and would like you to know that I am here to help.

Unfortunately, the ultrasound does detect cancer (hepatocellular carcinoma of the liver) along with a spread to the gall bladder, but this needs confirmation. Unfortunately, cancer of the liver is confirmed and in most cases a presentation seen similar to the one seen in this ultrasound investigation is due to gall bladder spread of the cancer (called metastasis).

I hope I have explained things in a manner best understood by you. I am extremely sorry to have to inform you about this. Please feel free to write back to me for any further clarifications, I would be more than happy to help you.

Best wishes.

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

Follow up: Dr. Shoaib Khan (4 hours later)

Hello Doctor;

Thanks for your response.

could you please suggest the stage of cancer and confirm if it is curable?

Best Regards
XXXXX

Answered by Dr. Shoaib Khan (9 hours later)

Brief Answer:
Staging can be done only with CT scan of abdomen

Detailed Answer:
Hello XXXXXXX

The staging of the cancer cannot be done with the help of a simple ultrasound investigation as it is not equipped enough to predict the grade/stage. For this reason the diagnostic center has advised a CT scan of the abdomen, an MRI or PET scan may also be used but are more extensive and expensive, and in my opinion a CT scan should more than suffice.

The CT scan will help in accurate staging of the cancer ma'am. Please feel free to write back to me for any further clarifications, I am always available to help.

Best wishes.

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

Follow up: Dr. Shoaib Khan (55 minutes later)

Thanks doctor

Final question: Is it HCC for sure or can be a benign tumor also. He has undergone ct scan and blood test. We are waiting for reports. the doctor is recommending a biopsy too. My father never had any liver related issues such as cirrohsis, hepatitis-B, C or never consumed alcohol. what could have caused this. His previous blood tests were all normal

Answered by Dr. Shoaib Khan (31 minutes later)

Brief Answer:
Almost 70% confirmed it is HCC

Detailed Answer:
Hello once again ma'am.

HCC has a particular pattern which would have been observed during the ultrasound examination XXXXXXX But then again, any diagnosis of cancer is confirmed only with the help of investigations like a CT scan or MRI and a definitive laboratory tissue sample study from a biopsy.

So please go ahead with the biopsy to confirm/rule out HCC. As of now, cancer is more likely due to possible signs of a metastasis to the gall bladder seen on the ultrasound scan.

I hope this makes things a little more clear for you ma'am. Please feel free to write to me about anything, anytime. I am always available to help.

Best wishes and God bless.

Note: For further queries related to kidney problems Click here.

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