Respected Doctors , <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:" /><o:p></o:p>
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My daughter aged 18 suffered from stomach pain on 5<SUP>th</SUP>,6<SUP>th</SUP> and 7<SUP>th</SUP> Feb’08.<o:p></o:p>
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On 8th Feb'08 she was shown to Dr( Gynocologist ). After undergone ultra sound scan (in which a solid hepatic mass was observed in Right lobe of liver ), Dr. advised her to go to a Gastroenterologist .<o:p></o:p>
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On 11.2.08 , she was shown to Dr.( Surgeon in GI ) and following Tests/Diagnosis/Treatment have been organized.<o:p></o:p>
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11.02.2008 - Ultrasound Scan – Atrophic changes in Rt.lobe of liver with hypertrophy of quadrate lobe and thrombosis of portal vein and portal cavernoma.<o:p></o:p>
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11.02.2008-Upper GI Endoscopy & Colonoscopy- Normal
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11.02.2008 - Biochemistry – Liver Function Test , AFT, CBP and Serum Creatine<o:p></o:p>
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12.02.2008 - CT Scan – 1.Heterogeniously enhancing lesion in right lobe with non visualized right portal vein(! Compressed ) and isodense in delayed phase 2. Few small lesions in left lobe. 3.No Ascites - ! Atypical hemangioma , ! Adenoma , ! Mesenchymal lesion.<o:p></o:p>
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After going through all the above reports Dr. suggested her to under go Diagnostic Laparoscopy.<o:p></o:p>
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14.02.2008 - Admitted in the hospital and ECG , RBG , Serum Electrolytes , ProthambinTime , ESR , FBG , X Ray etc., were conducted.<o:p></o:p>
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15.02.2008 - Diagnostic Laparoscopy Surgery + FNAC + Punch Biopsy was conducted. ( Operative findings : Large tumor arising from right lobe of liver and Multiple smaller nodules found in left lobe. )<o:p></o:p>
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21/22.02.2008 – Biopsy and Cytology Reports say No evidence of Malignancy and Features are that of steatosis of liver.<o:p></o:p>
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After going through the above reports, Dr. suggested her to under go MRI for further investigation.<o:p></o:p>
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28.02.2008 – MRI Test – Right lobe liver well encapsulated heterogeneously enhancing mass lesion with non opacified portal vein. Suggests the possibility of neoplastic lesion probably fibrolamellar HCC. Segment 8 lesions probably represents metastasis.<o:p></o:p>
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Due to the above report Dr. suggested her to under go Tru cut liver biopsy .<o:p></o:p>
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01.03.2008 – Tru cut liver biopsy conducted<o:p></o:p>
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06.03.2008 – Report of Tru cut biopsy suggested that Adenoma needs exclusion.<o:p></o:p>
<SUP><o:p> </o:p></SUP>After going through the above reports ,Dr. suggested her to under go surgery for removal of mass from the liver lobes.<o:p></o:p>
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After taking opinions from other surgeons and radiologists , she has been admitted in the hospital for surgery.<o:p></o:p>
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12.03.2008 - Admitted in the hospital and CBP , BG&T , LFT , ProthambinTime , Immunology ,ECG , X Ray FBG , Serum Electrolytes etc., were conducted.<o:p></o:p>
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14.03.2008 – Exploratory Laparotomy + Wedge Biopsy of Left Lobe SOL + Tru cut Biopsy of Right lobe SOL conducted.<o:p></o:p>
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Operation Findings – <o:p></o:p>
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(1). Evidence of right lobe segment 5,6,7 – 10x 8 cm large exophytic mass.<o:p></o:p>
(2) Trucut biopsy and frozen – s/o adenoma. <o:p></o:p>
(3) Evidence of multiple adenoma – Palpable in bothright and left lobe . <o:p></o:p>
(4) Left lobe 3x2 cm adenoma – wedge excision and frozen – s/o adenoma –No evidence of malignancy. <o:p></o:p>
(5) No ascites / deposits.<o:p></o:p>
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In view of multiple SOL presenting both lobes of liver excision was abandoned. Frozen section suggested hepatic adenoma.<o:p></o:p>
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Dr. indicated the necessity for Liver Transplantation in future ( after two or three years ) if multiple adenomas create problem. <o:p></o:p>
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19.03.2008 – Discharged from hospital. Advised three weeks post operative care and rest.<o:p></o:p>
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As mass of size 10 X 8 cm ( even though benign only ) could not be removed , what will be future course of action AYURVEDA suggests as treatment to my daughter <o:p></o:p>
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Thanking you <o:p></o:p>
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