What Does This Following Lab Report Indicate?

Posted on Tue, 16 Aug 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 16 Aug 2016 Answered on

Tue, 13 Sep 2016 Last reviewed on

Question : 78 yr old female; 156 pounds; 10 cm tumor INSIDE liver; ALP level at 119 & low ABS immature granulocytes (.2); calcium level is higher as well- had parathyroid surgery about 6 yrs ago. I am meeting with a surgeon on the 31st but need to know what I should be prepared for with results and what to ask.

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
parathyroid and this liver tumor most likely unrelated

Detailed Answer:
Hi
thanks for your query.

We need to look at the characteristics of the tumor, likely benign or malignant. To this end, a contrast enhanced CT scan is mandatory. If this suggests malignancy then we should biopsy it. Serum alfaprotein also helps to some extent to distinguish between benign or malignant.

If it is proven to be malignant with no lesion identified anywhere else in the body, then best is to try surgery. if that is not feasible, then other modalities.

You can discuss these points with the oncologist.

Hope this helps.
Regards

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

Follow up: Dr. Indranil Ghosh (49 minutes later)

Would it be your assumption that the high apl rate, having increased, would indicate liver cancer?? And having a large tumor that would need dissection seems to be an impossible surgery?! Is it possible to go thru chemo for that? And how do we not assume mastasisis??

Answered by Dr. Indranil Ghosh (7 hours later)

Brief Answer:
no this alp does not necessarily mean cancer

Detailed Answer:
Just the size doesn't indicate inoperability. We need to look at the remaining liver, presence of chronic liver disease, general health and comorbidites. Chemo does not work well in liver cancer. Other modalities like embolisation to choke the blood supply work better, if required.

I am not ruling out metastatic disease. As I mentioned, if there is no other lesions anywhere in the body then we can rule out metastases reasonably. The biopsy also helps to distinguish.

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