|
His current state has the following history of onset:
- 8 weeks ago, began having diarrhea which continues to this date and keeps him
up at night having to go every few hours
- Sharp very intense lower right quadrant pain that started 6 weeks ago, lasted
a few days but stopped and has not returned
- Fatigue / loss of energy
- Nausea, feeling as though needs to burp but cannot
- Weight loss of 31 pounds over the last 6 months (weight was 221 now 190). Has
improved his diet to healthier (reduced cholesterol die) eating a month ago.
TESTS PERFORMED:
December 2009 @ reg checkup visit, routine SGOT, SGPT, GGTP performed. Only
abnormal was GGTP, which was 92 as compared to the lab's stated normal range of
7-64.
March 2010 - retested SGOT, SGPT, GGTP, and only the GGTP was elevated, but had
improved to 82. Tests for hepatitis all negative. Doctor suspects nonalcoholic
fatty liver disease.
March 2010 - abdominal ultrasound with emphasis on liver area - completely
normal
March 2010 - still having problems, referred for ct of abdomen which revealed
mass 15 cm x 10 cm x 8 cm in one lobe of liver "suspicious for hepatocellular
carcimona". Now has been referred for biopsy next week.
QUESTION:
Is it plausible that such a mass could be missed by ultrasound? This does not
make sense to me. Is there any differential diagnosis given his history?
Your input is very sincerely appreciated.
|
