Rapid Growth of Liver Tumors: Risks and Next Steps - Gastroenterology and Hepatology

Liver tumors (two lesions) grew from 2.9 cm to 6.9 cm within three months?

Hello Dr.
Chen, my wife (37 years old) had a health check-up in mid-August, and an ultrasound revealed two tumors in her liver, each approximately 2.9 cm.
The CA 19-9 level was elevated, around 80.
Later, in mid-September, she went to the hospital for further examination, and the ultrasound showed that the tumors had grown to nearly 5 cm.
A CT scan was immediately arranged, and blood tests were conducted to check the results.
Subsequently, after a diagnosis was confirmed, we postponed the appointment to review the CT report until 10/24, where we found that the tumors had increased to 6.9 cm, and the CA 19-9 level from mid-September had decreased to 39.
Under the physician's guidance, an MRI is scheduled for next Tuesday (11/2).
We are very worried and would like to ask whether this is benign or malignant.
Thank you.

CT, 40~49 year old female. Ask Date: 2022/10/24

Dr. Chen Shidian reply Gastroenterology and Hepatology

Await imaging report; fine needle aspiration biopsy may be necessary.

Reply Date: 2022/10/24

More Info

The rapid growth of liver tumors, especially in the context of your wife's recent health checks, is understandably concerning. Based on the information provided, it appears that your wife has experienced a significant increase in the size of her liver tumors within a short period. Initially detected at approximately 2.9 cm, the tumors have grown to 6.9 cm in a matter of months, which raises important questions regarding their nature—whether they are benign or malignant.

Firstly, the CA19-9 marker is often used in the context of gastrointestinal cancers, particularly pancreatic cancer, but it can also be elevated in liver conditions. An initial reading of over 80, followed by a decrease to 39, may suggest that while there was a concern, the situation may not be as dire as initially thought. However, it is crucial to interpret these values in conjunction with imaging studies and clinical findings.

The rapid growth of tumors in the liver can be indicative of malignancy, particularly if they are associated with elevated tumor markers and significant changes in size over a short period. While benign tumors such as hemangiomas or focal nodular hyperplasia can occur in the liver, they typically do not exhibit such rapid growth. Therefore, the concern for a malignant process, such as hepatocellular carcinoma (HCC) or metastatic disease, must be taken seriously.

The next steps in management typically involve further imaging studies, such as MRI, which can provide more detailed information about the tumors' characteristics, including their vascularity, composition, and any potential invasion into surrounding structures. A biopsy may also be warranted to obtain histological confirmation of the tumor type, which is essential for determining the appropriate treatment strategy.

In terms of treatment options, if the tumors are confirmed to be malignant, the management may include surgical resection, ablation therapies, or systemic treatments depending on the tumor's stage, size, and the patient's overall health. If the tumors are benign but symptomatic or causing complications, surgical intervention may still be considered.

It is also important to consider the patient's overall liver function, especially in the context of any underlying liver disease, such as hepatitis or cirrhosis, which can complicate treatment options and prognosis.

In summary, while the rapid growth of liver tumors is concerning and warrants thorough investigation, it is essential to await the results of the upcoming MRI and any potential biopsy to establish a definitive diagnosis. The healthcare team will then be able to provide a tailored treatment plan based on the findings. In the meantime, maintaining open communication with the healthcare providers and addressing any concerns or questions can help alleviate some anxiety during this uncertain period.

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