Rebecca asks:
I have a 7-centimeter liver hemangioma.  Do these ever shrink on their own?

Anil Rustgi, MD responds:
A hepatic hemangioma, or hemangioma of the liver, is a noncancerous liver tumor consisting of dilated blood vessels. It is believed to be a birth defect and is usually not discovered until medical pictures are taken of the liver for some other reason.

In rare cases, hemangiomas may cause bleeding or interfere with organ function, depending on their location. Most hepatic hemangiomas are treated only if there is persistent pain. No medical therapy is known to reduce the size or eliminate hepatic hemangiomas — surgical removal is the only treatment.

A Penn hepatologist, a physician specializing in diseases of the liver, can evaluate your condition. To schedule an appointment, please call 800.789.PENN or request an appointment online.

Anna asks:
I have an uncomfortable bloated feeling in my upper abdomen and a nagging ache in my back that sometimes includes numbness or a tingling feeling. I drink close to a bottle of wine every night and a little more on the weekends. I know it's not good for me and I am trying to cut down.

I have had a CT scan, colonoscopy and ultrasound — all have revealed nothing. My blood tests have come back normal. My doctor said my liver enzymes are perfect and if my liver was damaged enough to hurt, this would show up in blood work. Is it possible that a damaged liver would not show up in routine blood work? Are there other tests for liver disease?

Anil Rustgi, MD responds:
The symptoms you describe could indicate any number of conditions. In addition to abdominal pain and swelling, symptoms of liver disease could include jaundice — discolored skin and eyes that appear yellowish, itchy skin, chronic fatigue, nausea, loss of appetite or abnormally colored urine or stool.

For women, having more than one drink a day over many years may be enough to lead to cirrhosis — irreversible scarring that causes the liver to shrink to a fraction of its size. Excessive alcohol consumption is a leading cause of liver disease.

In addition to standard blood tests, a liver biopsy or liver scan is sometimes used to diagnose liver disease or confirm other test results. A biopsy involves removing a liver sample for examination. A liver scan uses a radioactive material, injected into a vein, to help determine liver function.

A Penn hepatologist, a physician specializing in diseases of the liver, can evaluate your condition. To schedule an appointment, please call 800.789.PENN or request an appointment online.

Andrea asks:
I have seen Chinese herbal ads on web sites discussing hemangiomas of the liver – Hemantin, Hemnotab, and so on. Are these remedies effective and safe?

Anil Rustgi, MD responds:
A hepatic hemangioma, or hemangioma of the liver, is a noncancerous liver tumor consisting of dilated blood vessels. It is believed to be a birth defect and is usually not discovered until medical pictures are taken of the liver for some other reason.

Hepatic hemangiomas can occur at anytime, but are most common in women in their 30s to 50s. Most cavernous hemangiomas do not show symptoms. In rare cases, hemangiomas may cause bleeding or interfere with organ function, depending on their location.

Most hepatic hemangiomas are treated only if there is persistent pain. No medical or herbal therapy is known to reduce the size or eliminate hepatic hemangiomas – surgical removal is the only treatment.

A Penn hepatologist, a physician who specializes in diseases of the liver, can evaluate your condition. To schedule an appointment, please call 800.789.PENN or request an appointment online.

Susan asks:
My husband is 42 years old, overweight and was taking Lipitor®. Due to liver function test results, he was taken off the medicine last year. He's been off of it for over eight months and his levels are still high. He had a CT scan of the abdomen and pelvis – the contrast was normal. His doctor doesn't know why the levels are still high. Do you have any suggestions as to what can be going on? What is the next step?

Thomas Faust, MD responds:
Lipitor® is an atorvastatin medication. It is used together with lifestyle changes (diet, weight-loss and exercise) to reduce the amount of cholesterol and other fatty substances in the blood. Atorvastatin works by slowing the production of cholesterol in the body. For a small number of patients, atorvastatin can cause liver problems.

There are a number of liver function blood tests used to diagnose liver problems. It is important to diagnose liver disease early, as beginning stages may show no noticeable symptoms to the patient.

Your husband's doctor may consider referring him to a Penn gastroenterologist for further testing. To set up an appointment, please call 800.789.PENN (7366) or request an appointment online.

Kris asks:
I am a 43-year-old female with an asymptomatic liver hemangioma, which has grown over the past five years. It has been suggested that I be evaluated by a gastrointestinal liver specialist. Is there a physician in your practice that specializes in evaluation of liver tumors – specifically hemangioma?

Thomas Faust, MD responds:
A hepatic hemangioma is a noncancerous liver tumor made of dilated blood vessels. Believed to be a birth defect, it is the most common noncancerous tumor of the liver. Hepatic hemangiomas can occur at anytime, but are most common in women age 30 to 50. Most hepatic hemangiomas are treated only if there is persistent pain, bleeding or interference with other organ functions.

Dr. Faust is a Penn gastroenterologist who specializes in liver disease. He sees patients at the Hospital of the University of Pennsylvania and at Penn Medicine at Radnor. You can schedule an appointment with Dr. Faust by calling 800.789.PENN (7366) or you can also request an appointment online.