Call from Moffitt to explain PET results

Here is what the PET scan results showed.

Abdomen/pelvis: A mass in the posterior right hepatic lobe (image 134) has SUV maximum 16.2.

There is a small focus of heterogeneous uptake in the lateral left hepatic lobe (image 141) SUV maximum 5.1 compared to "normal" liver SUV maximum 4.8.

There is diffuse uptake in the gastric antrum and duodenal sweep (image 151) SUV maximum 7.6.

There is no focal abnormal prostate gland uptake. Avid

There is a small focus in the left posterior prostate gland (image 247) SUV maximum 4.1 and a focus in the right posterior prostate gland SUV maximum 4.7.

Impression:

1. There is a hypermetabolic posterior right hepatic lobe mass and indeterminate focal uptake lateral left hepatic lobe.

2. There are small avid posterior prostate gland foci x2. Follow-up and/or further evaluation are recommended.

3. Diffuse gastric antrum and duodenal sweep uptake may be physiologic or related to inflammation. Clinical correlation is recommended.

 

I received a call from Kelly, the PA at Moffitt, to explain these results.

1)      The right hepatic lobe is the area that we already knew about.  So, this is as expected.  The findings on the left node are “a little above normal”.  No other scans have shown anything on the left side, so she said that Dr Denbo will look at that area while in surgery.  Hopefully it is nothing, but if they find something, they will try to take care of it.

2)      The prostate gland tends to light up with this type of FDG PET scan.  She suggested I follow up with my primary to do a PSA blood test.  She did not seem overly concerned.

3)      This area is most likely the area that was found during the EDG.  Not something that was of any concern

Since there was no direct mention of Bile Duct in this report, we asked “Does this still mean this is bile duct cancer?”.  Her answer was basically, “The bile ducts are like the roots of a tree, and the liver is the soil.  Therefore, when there is a mass in the liver, the bile ducts just intertwine with the liver and become one.”  She said that the cancer markers from the biopsy are what they are using to identify the type.  Since the biopsy indicated it could be stomach or pancreas, but not liver, they ran the other tests to check for those.  They have so far ruled out all of those types from the various tests they have run on me.  By eliminating those, they are left with Bile Duct as the culprit.  After they take the mass out, they will do biopsies on it, and that will determine the further treatment plans.

All in all, I think the news was very positive.   Nothing NEW was found.

My surgery is scheduled for March 20th.  The surgery will be to remove the mass from the right lobe of my liver.  To do this, they will be taking about 1/2 of the right lobe of the liver. (This is about 35% of my total liver).  They will also be removing my galbladder and some lymph nodes that are in the area.  

I will be in the hospital for 4-6 days. 

We asked a bunch of questions about surgery and recovery.  But I am going to save them to post AFTER I am out of surgery, and the nurses there have given us our directions.