Mass on liver after gallbladder removal?

Patient

Q: I am a 23 year old female. I was feeling fine all day feb 11th tell I went to go to bed. After laying down I had a very sharp pain in my abdominal area. I went into the er an I had my gallbladder removed on the 12th of feb, It was an emergence procedure. After I was free from the hospital, I was unable to hold down any foods. This went for about 5 days and I went back into the er knowing that something was wrong. While there they noticed that they didnt get all the stones out when they removed my gallbladder, so I had another procedure to remove the rest of it. that happened on the 18th of feb. After that they checked my liver enzymes, and they were "threw the roof" as the doctor said. So I had to stay in the hospital tell they went down. They were still not at a normal level when they let me go home but they were not as high.

Now after my check up I was told that I have a mass on my liver. they think its Focal nodular hyperplasia, which I was told that its nothing to worry about as long as it does not grow. Right now its about 7cm.

my questions is would the problems I had before cause the mass to form? or could it be something else that caused the mass and that messed up the gallbladder? I have had no other medical problems my whole life.

Symptoms:  Mass on liver
Doctor

A:   Hello,
Thank you for your query at AskTheDoctor.com

I deeply appreciate your concern.
You have undergone 2 surgeries within a very small time period and you were not guided properly regarding the liver mass. Normally prior to any gall-bladder surgery, an LFT and a USG/CECT is mandatory.
There is no justification in missing a 7 cm liver mass preoperatively and definitely your liver enzymes were altered preoperatively which should have been controlled before proceeding with the surgery.

I would like you to go for a second opinion to a surgical gastroenterologist. If the diagnosis is focal nodular hyperplasia then there is nothing to worry as it is a benign tumour and does not need any treatment. Kindly stop taking OCP as focal nodular hyperplasia is associated with excessive OCP intake.

However, focal nodular hyperplasia can be easily confused with fibrolamellar variety of hepatocellular carcinoma.this fibrolamellar variety of hepatocellular carcinoma is malignant though not as aggressive as primary hepatocellular carcinoma and 50-75% resectable with a better prognosis. Kindly get a CECT, sulphur colloid liver scan which is diagnostic for FNH. LFT, Serum AFP will also confirm the diagnosis.

Biopsy report will also help in confirming the diagnosis.

Hope this was helpful,
Regards

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