49 yr old woman, history of breast cancer (double mast, ER/PR-, no nodes, no mets, regular checks, since 2008), with history of Irritable Bowel syndrome. 5'4", 133lb, BP 110/70, smaller build.
I recently developed new pain- abt a month now- under right rib cage. Coming and going. Defiitely worse in the am, relief with bm usually, alternating btw cons and diarrhea. Stools flatter or long. Have been in very stressful situation (moved loved one to hospice), so attributed to stress aggravated IBS. Pain started to refer to right back shoulder blade. Concerned, mentioned to gyn- no, not the correct doctor, but in for yearly, who suggested gallstones and order an ab ultrasound. Pain comes and goes, not severe, but seems to go when I am able to go to the bathroom.
US results are back and I'm very alarmed. There are no gallstones, but report is showing liver is at borderline size of large. Actually, as I am a smaller built woman, I fear it IS rather enlarger. (attaching report). "the liver is borderline in size measuring 17.3 cm in length. This may be related to Riedels' lobe."
I have had a few CTs done over the years and none have ever mentioned a larger liver. (There has been noted a less than 2mm hypodense spot too small to characterize, but it has remained unchanged over the years, so deemed not something to worry about.)
I also recently had bloodwork done. AST and ALT are normal, and in fact, lower than on past reports.
Of course-- I am fearing liver metastasis from the breast cancer. It's been 7 years now and I know that triple negs tend to metastasize early( Was Stage 1, 1 cm with no node involvement. Chemo and breast removal), so I'm hoping that counts in my favor.
I know ultrasounds have limits. My question is this--- with normal liver enzymes and no hepatic masses noted-- does this enlarged liver still point to cancer.
I guess I am just frightened and looking for a little clarity and hope to hang on to while I wait to get in for a CT.
Thank you for your consideration
Category: Family Physician-GP