Our Summary

A 32-year-old woman, who was pregnant for the second time and in her 33rd week of pregnancy, came seeking a third opinion about a large mass found in her unborn baby’s liver. She and her partner were considering ending the pregnancy as they were initially told it could be a type of liver cancer called hepatoblastoma. In our clinic, we performed special ultrasound and imaging tests that suggested the mass was a hemangioma, which is a non-cancerous tumor. To be sure, we performed a biopsy (a procedure to extract a small sample of the mass) which confirmed it was indeed a benign (harmless) hemangioma. After learning this, the couple decided to continue with the pregnancy.

FAQs

  1. What imaging techniques were used to diagnose the fetal liver mass?
  2. How was the liver biopsy performed to confirm the diagnosis of the fetal liver mass?
  3. What is a benign hemangioma and how does it affect pregnancy?

Doctor’s Tip

A doctor might advise a patient undergoing a liver biopsy to avoid taking blood thinning medications before the procedure to reduce the risk of bleeding. They may also recommend fasting for a certain period of time before the biopsy to ensure accurate results. Additionally, the doctor may suggest discussing any concerns or questions about the procedure with them beforehand to alleviate any anxiety or uncertainty.

Suitable For

Patients who are typically recommended for liver biopsy include those with suspected liver diseases such as cirrhosis, hepatitis, fatty liver disease, liver cancer, autoimmune liver disease, and genetic liver disorders. Additionally, patients with unexplained abnormal liver function tests, unexplained jaundice, or unexplained liver enlargement may also be recommended for a liver biopsy. Other indications for liver biopsy include monitoring the progression of a known liver disease, evaluating the effectiveness of treatment, and determining the extent of liver damage.

Timeline

Before liver biopsy:

  • Patient is referred for a third opinion regarding a large fetal liver mass at 33 weeks’ gestation
  • Couple seeks approval for termination of pregnancy due to differential diagnosis of hepatoblastoma
  • Specialized ultrasound and fetal magnetic resonance imaging are repeated in our unit
  • Results are consistent with a presumed diagnosis of hemangioma

After liver biopsy:

  • Tru-Cut® liver biopsy is performed confirming a benign hemangioma
  • Couple opts to continue with the pregnancy

What to Ask Your Doctor

  1. What is the purpose of the liver biopsy in my case?
  2. How will the liver biopsy be performed?
  3. Are there any risks or potential complications associated with the liver biopsy?
  4. How long will it take to get the results of the liver biopsy?
  5. What will the results of the liver biopsy tell us about my condition?
  6. Will the liver biopsy require any special preparation on my part?
  7. Are there any specific post-procedure instructions I need to follow after the liver biopsy?
  8. Will I need any follow-up appointments or tests after the liver biopsy?
  9. Are there any alternative diagnostic tests or procedures that could be considered instead of a liver biopsy?
  10. What are the potential treatment options based on the results of the liver biopsy?

Reference

Authors: Jacquier E, Ruggiano I, Badr DA, Cannie MM, Carlin A, Jani JC. Journal: Fetal Diagn Ther. 2022;49(4):176-179. doi: 10.1159/000524447. Epub 2022 Apr 6. PMID: 35385848