Liver mass history and symptoms: Difference between revisions

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Latest revision as of 22:32, 29 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

The hallmark symptoms of liver mass, include right upper quadrant abdominal pain, pruritus, and unintentional weight loss. However, in some cases, liver masses may be asymptomatic. A positive history of chronic hepatitis, cirrhosis, nonalcoholic fatty liver disease, prolonged contraceptive use, and alcohol abuse may be suggestive of a liver mass. Symptoms related with liver mass will vary depending on the size and location of the tumor. Other symptoms of liver mass may also include loss of appetite, fatigue, nausea, and vomiting.

History

Obtaining the history is an important aspect of making a diagnosis of liver mass. Complete history will help determine the likelihood of malignancy, and the association with other conditions. Specific symptoms description such as duration, onset, and progression are important for making the diagnosis. Specific areas of focus when obtaining the history, are outlined below:^[1]

History
Personal history	Age Gender Recent travel history
Family history	Positive family history of liver diseases, such as: Crigler–Najjar syndrome Gilbert syndrome Dubin–Johnson syndrome Rotor's syndrome
Past Medical History	Previous hepatitis infection, such as: Hepatitis C infection Hepatitis B infection History of chronic liver disease Use of contraceptives
Social history	Positive history of smoking/alcohol abuse: Number of alcoholic beverages per week Number of years/months of active alcohol abuse Number of years/months of alcohol cessation

Symptoms

In most cases, liver masses are asymptomatic and are usually found incidentally.
The hallmark symptoms of liver mass may include right upper quadrant abdominal pain, pruritus, and unintentional weight loss.
Other symptoms that suggest liver mass, include:^[2]
- Abdominal pain
  - Dull pain
  - Pain radiating to the right scapular area or right shoulder
- Cachexia
- Fatigue
- Loss of appetite or anorexia
- Chest pain
- Generalized pruritus
- Nausea and vomiting

References

↑ Bonder A, Afdhal N (2012). "Evaluation of liver lesions". Clin Liver Dis. 16 (2): 271–83. doi:10.1016/j.cld.2012.03.001. PMID 22541698.
↑ Roche SP, Kobos R (2004). "Jaundice in the adult patient". Am Fam Physician. 69 (2): 299–304. PMID 14765767.

[pmid22541698-1] Bonder A, Afdhal N (2012). "Evaluation of liver lesions". Clin Liver Dis. 16 (2): 271–83. doi:10.1016/j.cld.2012.03.001. PMID 22541698.

[pmid14765767-2] Roche SP, Kobos R (2004). "Jaundice in the adult patient". Am Fam Physician. 69 (2): 299–304. PMID 14765767.

[1]

[2]

@@ Line 4: / Line 4: @@
 ==Overview==
+The hallmark symptoms of liver mass, include right upper quadrant [[abdominal pain]], [[pruritus]], and unintentional [[weight loss]]. However, in some cases, liver masses may be asymptomatic. A positive history of [[chronic hepatitis]], [[cirrhosis]], [[nonalcoholic fatty liver disease]], prolonged [[contraceptive]] use, and [[alcohol abuse]] may be suggestive of a liver mass. Symptoms related with liver mass will vary depending on the size and location of the [[tumor]]. Other symptoms of liver mass may also include loss of appetite, [[fatigue]], [[nausea, and vomiting]].
-The hallmark symptoms of liver mass, include: right upper quadrant abdominal pain, pruritus, and unintentional weight loss. However, in some cases, liver masses may be asymptomatic. A positive history of [[chronic hepatitis]], [[cirrhosis]], [[nonalcoholic fatty liver disease]], prolonged [[contraceptive]] use, and [[alcohol abuse]] may be suggestive of a liver mass. Symptoms related with liver mass will vary depending on the size and location of the tumor. Other symptoms of liver mass may also include: loss of appetite, fatigue, nausea, and vomiting.<ref name="pmid14765767">{{cite journal |vauthors=Roche SP, Kobos R |title=Jaundice in the adult patient |journal=Am Fam Physician |volume=69 |issue=2 |pages=299–304 |year=2004 |pmid=14765767 |doi= |url=}}</ref><ref name="pmid22541698">{{cite journal |vauthors=Bonder A, Afdhal N |title=Evaluation of liver lesions |journal=Clin Liver Dis |volume=16 |issue=2 |pages=271–83 |year=2012 |pmid=22541698 |doi=10.1016/j.cld.2012.03.001 |url=}}</ref>
 ==History==
-*Obtaining the history is an important aspect of making a diagnosis of liver mass. Complete history will help determine the likelihood of malignancy, and the association with other conditions. Specific symptoms description such as duration, onset, and progression are important for making the diagnosis. Specific areas of focus when obtaining the history, are outlined below:<ref name="pmid22541698">{{cite journal |vauthors=Bonder A, Afdhal N |title=Evaluation of liver lesions |journal=Clin Liver Dis |volume=16 |issue=2 |pages=271–83 |year=2012 |pmid=22541698 |doi=10.1016/j.cld.2012.03.001 |url=}}</ref>
+Obtaining the history is an important aspect of making a diagnosis of liver mass. Complete history will help determine the likelihood of [[malignancy]], and the association with other conditions. Specific symptoms description such as duration, onset, and progression are important for making the diagnosis. Specific areas of focus when obtaining the history, are outlined below:<ref name="pmid22541698">{{cite journal |vauthors=Bonder A, Afdhal N |title=Evaluation of liver lesions |journal=Clin Liver Dis |volume=16 |issue=2 |pages=271–83 |year=2012 |pmid=22541698 |doi=10.1016/j.cld.2012.03.001 |url=}}</ref>
+{|
-:*Age
+! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |History
-:*Gender
+|-
-:*Family history of cancer
+! align="center" style="background:#DCDCDC;" + |Personal history
-:*Personal history of cancer
+| align="left" style="background:#F5F5F5;" + |
-:*Positive family history of liver diseases, such as:
+*Age
-::*Crigler–Najjar
+*Gender
-::*Gilbert syndrome
+*Recent travel history
-::*Dubin–Johnson syndrome
+|-
-::*Rotors syndrome
+! align="center" style="background:#DCDCDC;" + |Family history
-:*History of chronic liver disease
+| align="left" style="background:#F5F5F5;" + |Positive family history of liver diseases, such as:
-:*Positive history of smoking/alcohol abuse
+*[[Crigler-Najjar syndrome|Crigler–Najjar syndrome]]
-::*Number of alcoholic beverages per week
+*[[Gilbert syndrome]]
-::*Number of years/months of active alcohol abuse
+*[[Dubin-Johnson syndrome|Dubin–Johnson syndrome]]
-::*Number of years/months of alcohol cessation
+*[[Rotor syndrome|Rotor's syndrome]]
-:*Recent travel history
+|-
-:*Use of contraceptives
+! align="center" style="background:#DCDCDC;" + |Past Medical History
-:*Previous hepatitis infection, such as:
+| align="left" style="background:#F5F5F5;" + |
-::*Hepatitis C infection
+* Previous [[hepatitis]] infection, such as:
-::*Hepatitis B infection
+**[[Hepatitis C]] infection
+**[[Hepatitis B]] infection
+*History of [[chronic liver disease]]
+* Use of [[Birth control|contraceptives]]
+|-
+! align="center" style="background:#DCDCDC;" + |Social history
+| align="left" style="background:#F5F5F5;" + |Positive history of [[smoking]]/[[Alcoholism|alcohol abuse]]:
+* Number of alcoholic beverages per week
+* Number of years/months of active [[Alcoholism|alcohol abuse]]
+* Number of years/months of alcohol cessation
+|}
-==Common Symptoms==
+==Symptoms==
 *In most cases, liver masses are [[asymptomatic]] and are usually found incidentally.
-*The hallmark symptoms of liver mass, may include: right upper quadrant abdominal pain, pruritus, and unintentional weight loss.
+*The hallmark symptoms of liver mass may include right upper quadrant [[abdominal pain]], [[Itch|pruritus]], and unintentional [[weight loss]].
 *Other symptoms that suggest liver mass, include:<ref name="pmid14765767">{{cite journal |vauthors=Roche SP, Kobos R |title=Jaundice in the adult patient |journal=Am Fam Physician |volume=69 |issue=2 |pages=299–304 |year=2004 |pmid=14765767 |doi= |url=}}</ref>
-:*[[Abdominal pain]]
+**[[Abdominal pain]]
-::*Dull pain
+***Dull pain
-::*Pain radiating to the right scapular area or right shoulder
+***Pain radiating to the right scapular area or right shoulder
-:*[[Cachexia]]
+**[[Cachexia]]
-:*[[Fatigue]]
+**[[Fatigue]]
-:*Loss of [[appetite]] or [[anorexia]]
+**Loss of [[appetite]] or [[anorexia]]
-:*[[Chest pain]]
+**[[Chest pain]]
-:*Generalized [[pruritus]]
+**Generalized [[pruritus]]
-:*[[Nausea]]
+**[[Nausea and vomiting]]
-:*[[Emesis]]
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