What would you do if this is your patient, you or your family?

Here is a patient I just had: 37 yo lady at 27 weeks of pregnancy, who had abdominal pain, had an ultrasound, found to have a hyperascular mass in the left hepatic lobe (about 4cm in diameter, surface of left lobe). Healthy woman without underlying liver disease or malignancy, likely a benign liver tumor. Differential diagnosis is focal nodlar hyperpaia (FNH) or hepatic adenoma (it is not a hemangioma as the lesion contains a lot of blood vessels seen by color Doppler). Hepatic adenoma, although benign, could bleed during the third trimester or postpartum, thus surgical resection at second trimester may be indicated: she is at the beginning of the third trimester, so it is a bit late for surgery now.

Her choice was 1) do nothing, wait till delivery, 2) MRI with gadolinium contrast (pregnancy category C drug) or 3) contrast enhanced ultrasound (Definity, Pregnancy category B drug). The patient agreed to do a contrast ultrasound with Definity.

I will try to upload the movie, but am not sure if it would work. Story continues....