Any doctors around? How fucked am I?

[Metabolicallycomplicated]

I had an MRI on my liver due to some lesions found on a totally unrelated ultrasound. They suspected NAFLD given my weight etc but instead They’ve found something more worrying, but the GP I spoke to couldn’t give me a straight answer as to what the MRI report means. Is this most likely benign or most likely not? GP treated me like I was going to crumble but I’m a very pragmatic person, I just need to understand what I’m looking at here.

Im 33, I have a 2 year old DS and I just need to know how worried I need to be here instead of waiting another few weeks for the next MRI and results from that. If I’ve got liver cancer I know how bad that is and I need to start getting ducks lined up and quacking sooner rather than later.

So if you’re a doctor/ medical and you read the below report, what would you be thinking? You can be honest, I’m completely aware no one can diagnose me from the below, I just need probabilities and ballparks.

I got found to have multiple liver lesions after an unrelated scan, very much like you. Got referred for the contrast MRI. Thought I was going to die. Don’t think I’ve ever been as anxious. They were benign adenomas. Now if I ever have scans they always say ‘don’t worry but we’ve found some lesions…’ and I dig out the old images and they’re the same.

The doctor said to me that when you start looking at insides you always find things that are worrying, but vast vast majority of the time they are nothing.

hopefully you have PCOS and benign liver lesions. That’s the most likely scenario

So, I’ve had cancer, also had a recent biopsy for endometrial cancer due to thickened wall and bleeding (was fine). Recently I was talking to a nurse about whether I should pay for a yearly mri scan and she said it can throw up all sorts of things that can mess with your head, and as I’d be paying for a private scan, I couldn’t afford to have them investigated, and the NHS may not want to follow up or if they did it would take time and all that time I’d be worrying.

So my message from that as a non medical person is that it is not uncommon for harmless things to show up on a MRI , and you just need to wait for the investigation. It sounds from more expert pp that the chances are good it’s nothing serious.

My BIL had a scan that stumbled across a hyper intense lesion in his pancreas! He went through so many PET scans ,ERCP ,referred to Kings liver unit and even referred to a MacMillan nurse …long story short,it was a benign nodule !
As hard as it is ,the sooner you get investigated,the sooner you will be reassured .
I would personally be reassured that your LFTs are normal and you don’t feel unwell.💐

I'm not a medical person but this seems to be the case. I googled it and came up with most liver lesions are benign but some can be cancerous.

Seems like they are doing further investigations. This must be very worrying for you. Hope all goes well.

I'm not a doctor @Metabolicallycomplicated but they're just saying it needs to be checked out.

People get health scares like this often, at least as they get older.

Praying that you get the all clear ASAP xx

1. Multiple Hypodense Lesions in the Liver: These are areas that appear less dense on the MRI and could indicate various conditions, ranging from benign cysts to malignant tumors.

   2. Focal Hyperintense Signal on T2-weighted Sequence: This suggests that there are areas in the liver that are showing up as brighter on T2-weighted MRI images, which could be due to a number of causes including inflammation, infection, or malignancy.

   3. Intermediate Signal on T1-weighted Sequence: The signal intensity is between the intensity of fluids and the surrounding liver tissue, which could be indicative of different types of liver lesions.

   4. No Diffusion Restriction: This often suggests that the lesions are not highly cellular, which can sometimes be a feature of benign lesions, but it is not definitive.

   5. Filling Defect in the Bile Duct: This means there is something within the bile duct that is blocking the normal flow of bile, which can be a gallstone or sludge, but could also represent a tumour.

   6. Mildly Prominent Bile Duct: This could be secondary to the filling defect causing a backup of bile.

   7. No Intrahepatic Biliary Radical Dilatation: Suggests that the bile ducts within the liver are not significantly dilated, which is usually a positive sign as dilatation can indicate a blockage higher up in the biliary tree.

   8. Normal Appearance of Spleen, Kidneys, and Pancreas: Indicates that these organs do not show any abnormalities on the MRI.

   9. Impression of Suspicious Multiple Focal Lesions: The radiologist is raising a concern for the potential of these lesions to be abnormal growths, such as adenoma (a type of benign tumor), metastasis (spread of cancer), or atypical haemangiomas (a benign tumor of blood vessels).

   10. Urgent Recall of Patient for Contrast Enhanced MRI Scan: The radiologist is recommending a more detailed MRI with contrast to better characterise the lesions and the filling defect in the bile duct.

Thanks everyone, I’m so glad I started this thread as I feel massively reassured even by the ‘worst case scenario’ posts because some of them I can debunk and even that’s helped settle me. Even the worst case ones I can’t fully debunk I can see are outside chances and I’ve gained some perspective from that so thank you all.

It’s Schrödinger’s cancer really isn’t it - it both is and isn’t there until proved either way so I’m choosing to just crack on and assume it’s not there until it is.

Between mid 30s to mid 40s I've had '2 week wait' or the equivalent about my womb (polyp), throat (overexertion), breasts twice (gristle, benign lesion), and currently waiting for one for a highly-likely-to-be-nothing-majorly-dodgy vaginal cyst. I just wanted to highlight how common it is @Metabolicallycomplicated . x None of them turned out to be anything significant.

That’s incorrect. They can’t see on this scan…

they’ll need the contrast and a bit more.

Have you had the pathology results back on your biopsy? That is, do you know what grade of hyperplasia the biopsy showed, ie simple or complex hyperplasia without atypia; simple or complex hyperplasia with atypia?

Thank you SO MUCH for this, this is so incredibly helpful.

No I’m still waiting for results, should be any day hopefully.

Some really helpful posts here, and some not so helpful ones.
With this report op, I would look at things holistically. You have no reduced liver function and you’re otherwise well. This swings the pendulum towards benign, as if you had a liver full of mets you would have probably had other signs, at least an altered liver function test. Obviously they’ll need to test further to characterise these lesions, which they’re going to do. But you would be amazed what you see in the body if you looked hard enough.

I’ve scanned thousands of livers over the years and picked up all sorts of lesions (I’m a Sonographer). A lot have been cancer / mets but many have been benign, even if they don’t look obviously benign at first. I remember one chap who had at least 20 lesions in the liver, the consultant radiologist was so sure it was mets. Turned out they were fat balls.

Wishing you the best of luck.

Not true.

My mother's x-ray for chest trouble and coughing stated "possible carcinoma".

I'm not making this up. 🙄

She was then referred for a PET scan which confirmed it.

Thank you, they originally diagnosed me with NAFLD off my ultrasound but the GP said she wanted to just refer for an MRI ‘to double check’. Off this report the GP said it’s definitely not NAFLD and it’s something else so I guess it’s a good thing she was thorough.

@penjil Sounds very blunt :( I don't think most of them write like that, whatever they see on a scan.

I do hope you won't have to wait too long for the pathology report.

I was also freezing cold when anaemic due to profuse uterine bleeds (post-menopausal; large uterus, large degenerating fibroids and thickened endometrial lining - at one point the lining also measured 22mm on ultrasound, but it measured as thinner than that on an MRI shortly afterwards). I also had dreadful restless legs in the evening and during the night which resolved after around 3 weeks once iron tablets had been prescribed.

My hyperplasia was graded simple hyperplasia without atypia. I was fitted with a Mirena IUD to thin the lining which self expelled a couple of weeks later. I was then put on low dose medroxyprogesterone (20mg Provera) for 12 months. This has thinned the lining and reversed the hyperplasia. I had actually stopped bleeding for several weeks before I started low dose medroxyprogesterone but started bleeding lightly but pretty much continuously a couple of weeks after starting it. As the lining is now deemed normal for someone of my age and my menopausal status and the hyperplasia has been reversed, I was able to come off Provera a few weeks ago and the almost continuous light bleeding has since stopped.

I hope it’s something benign and an incidental finding, like FNH. Good luck.

I feel for you OP and didn’t want to read and run.

When my son was almost one year old I felt ‘something’ around the area of my liver/stomach. I found it because I had intermittent discomfort there and I felt it when I had a prod around.

An ultrasound indicated I had some kind of tumour on my liver. Working diagnosis was adenoma. I had the hellish wait for a contrast MRI and the diagnosis was a completely benign tumour called ‘focal nodular hyperplasia’. I had another awful six months wait until they were able to confirm the diagnosis as the tumour hadn’t grown in that time. The only thing that kept me sane was the knowledge I didn’t have any red flag symptoms (apart from weight loss, but I was able to see how that was caused by stress).

That was 10 years ago now and I still remember how bloody awful it was and I wanted you to know I’m thinking of you.

Push for an MRI cancellation Xx

Hi Mri radiographer here. Wait until the next scan to get definitive report. Best wishes

@Metabolicallycomplicated Thank you so much for this thread. I’m in a similar situation to you (though different part of the body) and I’m going to try and follow your pragmatic approach to waiting. I’m fed up of catastrophising!

Good luck OP x

Some brilliant people and comments on this thread, thank you for sharing your knowledge ☺️

You don't have a gall bladder yet they say your gall bladder appears normal. I'd be asking for another scan, looks like you got someone else's!

Thank you so much for starting this thread. I have felt very down today because of various medical issues, tests, scans etc etc but this is all so sensible and measured it has made me feel much better.

A little bit of knowledge is a dangerous thing, @JennieTheZebra. You are putting 2 and 2 together and making 5000. A differential diagnosis a list of possible diagnoses, some common, some rare eg a chronic cough could be something common like acid reflux or asthma or something rare like lung cancer or sarcoidosis (or a million other things)…