Lesions, Cystic liver mets, vs Tumors

Hello Karen (@immmm) - Welcome to Mayo Connect, thank you for being an advocate for your best friend and helping her find information. Hopefully another Connect member will join the discussion and be able to offer more information. Until they do I did a quick search on Google Scholar (https://scholar.google.com/) and found something I think may explain it a little better. I searched for the phrase "cystic lesion of the liver" and it came up with a few good links that may help. Here is the list of links:
https://scholar.google.com/scholar?q=cystic+lesion+of+the+liver&hl=en&as_sdt=0%2C24&oq=cystic+lesion+o
Is your friend able to contact the doctor when she gets home? I think they would be able to offer the best explanation and at the same time answer any follow up questions she may have.

John

Hello @immmm

I appreciate your posting this interesting question. Many of us have been diagnosed with lesions on the liver - some of which represent benign lesions, others of us have metastasized tumors in the liver and others have had been diagnosed with cysts. I would certainly recommend that your friend contact her doctor's office to get some clarification on the type of lesion she has. I'm sure she needs to put her mind at ease. In the meantime, let's see what our other members have to say about this.

Has your friend been diagnosed with NETs? Was this MRI done to determine if there was any metastasis?

Teresa

Thank you for your prompt response. Yes, she has NETS with liver metastasis. This is a repeat MRI at one 1yr. It said "the bilobal mets appear similar, but some lesions such as the cystic lesion appears larger"--I hope she will follow up-- I questioned it when she let me read it and couldn't really find anything to clarify.

Thank you for the links. I hope she will follow up. I am in the medical field (PT- definitely not my area of expertise) but trying to help her be proactive and and her own advocate!

@immmm

I appreciate your giving us some background on your friend's history with NETs. I have personally had 3 surgeries for relatively small NETs in the duodenal bulb. The first one was removed by surgery in 2003 and last one was found and removed in 2016. I have had a lesion on my liver as well - however, it is unchanged in size over 5 years, so it is felt to be benign. Given the fact that my blood work and 24 urine is normal my doctor is not concerned.

In order to answer your question more thoroughly, I'm going to continue to search for a simpler answer to the different terms you mentioned in your original message.

I really appreciate the research that @johnbishop did on Google Scholar - good information, John!

If I may ask, has your friend had any surgeries? Does her doctor know where the primary NET is? Has she had a 68 Gallium PET scan yet? Is she seeking a second opinion?

Teresa

@immmm

Bless you for your assistance to your friend!

Teresa

Thank you so much for the responses! I have been out of pocket and just now able to respond. She has not had any surgeries. Her primary tumor was in the small intestine, mets to liver. She presently takes Lanreotide injections monthly. Her oncologist sent her to MD Anderson and that is the treatment they agreed on. She has had an octreoscan, gets a CT scan every 3 months. Thank you again for trying to help me get some answers.

Hello Karen, @immmm

Understanding the difference between lesions, cystic lesions, liver metastasis and tumors can be challenging. I found an article from Residents in Radiology Online that states:

"Cystic liver lesions, or fluid-containing lesions of the liver, are commonly encountered findings on radiologic examinations that may represent a broad spectrum of entities ranging from benign developmental cysts to malignant neoplasms. The wide range of pathologic processes that may result in cystic liver lesions can present a difficult diagnostic conundrum. The radiologist must carefully assess such imaging features as location, size, and unifocal or multifocal nature of the cyst or cysts as well as evaluate cyst complexity and associated findings. In addition, because radiologic features of various cystic liver lesions overlap, it is necessary to integrate imaging with clinical and laboratory findings to allow more definitive diagnosis."

As you can see, even for medical professionals the information from one image study alone, such as an MRI, is not enough for a full diagnosis. Here is the full article for furrther reading http://www.ajronline.org/doi/pdf/10.2214/AJR.10.5292

To determine next steps, such as further testing or a treatment plan, your friend's care team will piece together all the information they have gathered from imaging, clinical analysis and lab findings. Does she have her follow-up appointment to discuss next steps?

Rosemary,
Thank you! No wonder I couldn't decipher what the radiologist was saying! She has to speak with her doctor. There has been no discussion for any other treatment, she has followup every 3 months at MD Anderson, and oncologist visits with her before her shot. When I go with her, it was basic- how are you feeling? Do you need pain medicine, are you having any swelling of your lower extremities or shortness of breath. She is a positive person but is very passive and tends to say I'm doing pretty good, doing okay. I realize this may be the best and/or only treatment for her, again just trying to be an advocate and trying to find more out about this "not your average ""normal"" cancer".

Hi Karen @immmm

It might be helpful (before her next appointment) that you assist her in writing out some questions to ask her doctor. In addition to being passive - she just might feel overwhelmed. A little structure (such as having a list of questions) might help her communicate better at the appointments.

Teresa