Medical Oncologist
CION Cancer Clinics
When should you see a specialist about a liver lesion? | CION Cancer Clinics
See a specialist soon if the lesion sits in a liver with cirrhosis or hepatitis, if you have had cancer before, or if the report says suspicious. A simple cyst or typical haemangioma in a healthy liver can usually be followed by your own doctor. This page sets out who to see, how soon, what they will do, and the signs that mean going to hospital today. At CION Cancer Clinics, our team goes through your scan, blood test and biopsy reports with you and plans the next step.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- Do I need a specialist for a spot on my liver?
- Who should I see: a hepatologist, an oncologist or a surgeon?
- How quickly should I see someone about my report?
- What will the specialist actually do?
- Four things families tell us about liver spots
- What this page cannot tell you
- Common questions about seeing a liver specialist
The short answer
Do I need a specialist for a spot on my liver?
Not always, but some situations call for one without delay. A small lesion that the report calls a simple cyst or a typical haemangioma, in a healthy liver, can usually be followed by your own doctor. A lesion in someone with cirrhosis, hepatitis B or C, a past cancer, or a report that uses words like "suspicious" needs a specialist opinion soon.
Most spots are harmless, which is why the details matter
Most lesions found by accident on an ultrasound for a stomach ache are not cancer. Simple cysts, haemangiomas (a tangle of blood vessels) and patches of fatty liver are far more common. That is reassuring, but it is not a reason to ignore the advice on the report. The follow-up scan your doctor suggested is how a harmless spot is proved harmless.
Primary or secondary: the first question a specialist asks
A cancer that starts in the liver is called primary liver cancer, or HCC (hepatocellular carcinoma). A cancer that spread to the liver from the bowel, breast, stomach or elsewhere is secondary. If you have had another cancer, read about a lesion found during another cancer's scan, because the plan is different.
This page tells you when to ask for help. It cannot tell you what your spot is.Which specialist
Who should I see: a hepatologist, an oncologist or a surgeon?
Each one answers a different question. Many families see more than one, and the tumour board brings their views together.
Hepatologist (liver specialist)
Looks after the liver itself: cirrhosis, hepatitis B and C, fatty liver and liver function. The right first stop when the lesion sits in a liver that is already unwell.
Usually the right choice when
- You have cirrhosis or hepatitis B or C
- Your liver blood tests are abnormal
- You need antiviral treatment or regular surveillance
Radiologist
The doctor who reads the scan. A specialist liver radiologist decides whether a triple-phase CT or MRI is needed and what the pattern of contrast shows. A second reading of the same images often settles a doubtful report.
Medical oncologist
The right person when cancer is suspected, confirmed, or when you have had cancer before. An oncologist brings the case to the tumour board and plans the next step with the other specialists.
Usually the right choice when
- The report says suspicious, LR-4 or LR-5
- You have a past or current cancer elsewhere
- AFP, a liver tumour marker, is raised
Surgical oncologist
Assesses whether a lesion can be removed safely. Usually seen after the scans are complete, not as the first visit. More on this in which doctor treats liver cancer.
Not sure whether this applies to you?
Ask an oncologist
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When to go to hospital today
Do not wait for an appointment if you vomit blood, pass black or tarry stools, become newly confused or very drowsy, develop yellow eyes together with a fever, or have a high fever with shivering and pain under the right ribs. Go to the nearest emergency department today and take your scan report with you. These signs can mean bleeding, a liver infection or a liver that is struggling, and each one needs same-day care.
How soon
How quickly should I see someone about my report?
What you have
What to do
A simple cyst or typical haemangioma in a healthy liver, no symptoms
See your own doctor and follow the scan advice on the report
"Indeterminate", "SOL" or "further evaluation advised"
Arrange the suggested CT or MRI and a specialist visit within the next few weeks
Any new lesion with cirrhosis, hepatitis B or hepatitis C
See a hepatologist or oncologist this week
A lesion in someone who has had cancer elsewhere
Tell your oncologist this week
"Suspicious", "arterial enhancement with washout", LR-4 or LR-5
See an oncologist this week, with all scans on a disc
Weight loss, poor appetite or a swollen belly with the lesion
See a specialist this week
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
At the specialist visit
What will the specialist actually do?
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Look at the images, not only the report
Bring the CD or the online link to the scan. A typed report is one person's summary, and the specialist or radiologist will want to see the pictures themselves.
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Ask about the liver behind the lesion
Questions about alcohol, hepatitis, diabetes, weight and past illness are routine. Answer honestly. The rules for a lesion in a cirrhotic liver are different from those in a healthy one.
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Order the right next test
Often a triple-phase CT or a liver MRI, liver blood tests and AFP. CION arranges these through accredited diagnostic partners. A biopsy is not always needed, and the specialist will explain why.
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Decide between watching and acting
Many lesions are simply watched with a repeat scan. A lesion that looks like cancer goes to the tumour board, where oncologists, surgeons, radiologists and liver doctors decide the plan together.
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Tell you when the next check is due
Leave knowing what was decided, what the next test is, and who will call you with the result.
Commonly believed
Four things families tell us about liver spots
"No pain, so it cannot be serious."
Most liver lesions cause no pain, whether they are harmless or not. The absence of symptoms tells you nothing either way. The follow-up scan is what tells you.
"Seeing a cancer specialist means the doctor thinks it is cancer."
Oncologists see many people whose lesion turns out to be harmless. Being referred is a way of getting a firm answer quickly, not a verdict.
"A liver tonic or detox will shrink the spot first."
No tonic shrinks a liver lesion, and some herbal products can damage a liver that is already weak. Tell your doctor about anything you take, without worry of being judged.
"We should wait until after the family function."
For a simple cyst, a short wait rarely matters. For a lesion in a cirrhotic liver or a suspicious report, delay can narrow the choices. Ask the doctor which kind yours is before deciding to wait.
Being straight with you
What this page cannot tell you
It cannot tell you whether your lesion is cancer, and nobody can from a report alone. Words like "hypoechoic" or "SOL" describe how the spot looked on one scan. They do not name what it is. A specialist reading the images alongside your history and blood tests is the only way to an answer.
Who this page does not apply to
If you already have a diagnosis of liver cancer and a treatment plan, this page is not for you. Read about getting a second opinion on a liver cancer plan instead. Children with a liver mass are seen by paediatric teams, and the rules are different.
When the evidence is thin
For some small, unclear spots, specialists honestly disagree about whether to scan again or test further. If two doctors have told you different things, that is common. A tumour board review can help settle it.
If you are unsure which situation you are in, call the helpline and read out the impression line of your report. Someone will tell you who to see and how soon.Questions we are asked
Common questions about seeing a liver specialist
Should I see a hepatologist or an oncologist first?
If you have cirrhosis, hepatitis or abnormal liver tests and the report sounds reassuring, a hepatologist is a good first stop. If the report says suspicious, or you have had cancer before, see an oncologist. Either one will bring in the other when needed.
Is a general physician enough for a liver cyst?
For a simple cyst or a typical haemangioma in a healthy liver, your own physician can usually manage the follow-up. Ask a specialist if the report adds words like complex, septations, solid part or indeterminate, or if the cyst is causing symptoms.
What should I bring to the appointment?
Bring every scan on a CD or link, all reports in date order, recent liver blood tests and AFP if done, any hepatitis test results and a list of medicines and herbal products. Older scans are valuable, because a spot that has not changed for a long time is usually reassuring.
My doctor said repeat the scan later. Is that safe?
For many small, low-risk lesions it is the standard approach, not carelessness. What matters is that the repeat scan actually happens. Write down the date and the type of scan, and ask what change would bring you back sooner.
Will the specialist do a biopsy straight away?
Usually not. Many liver lesions are diagnosed from a good-quality CT or MRI, and some never need a needle at all. When a biopsy is needed, CION arranges it through partner hospitals and the specialist will explain the reason first.
Can I get a second opinion on the scan itself?
Yes. A specialist liver radiologist can reread the same images, which often avoids a repeat scan. CION can arrange this review and present the case at the tumour board if a plan is needed.
I have to travel from my district. Is one visit enough?
Often the first visit can be planned so the right scan and blood tests happen on the same trip. Call ahead with your reports so the team can tell you what to bring and what will be arranged before you travel.
How do I book a specialist opinion at CION?
Call the helpline with your report in hand. The team will ask about your scan, your liver history and any past cancer, then book you with the right specialist at the nearest centre. One helpline serves every CION centre.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- Liver UK (formerly British Liver Trust) — Benign liver tumours
- American College of Radiology — ACR Liver Imaging Reporting & Data System (LI-RADS®)
- American Cancer Society — Diagnosing Liver Cancer
- Cancer Research UK — Secondary liver cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
A spot was found on my liver: what does it mean?Start here if the report has only just arrivedWhat happens next after an incidental liver lesionThe usual sequence of scans and visitsQuestions to ask about an incidental liver lesionA list to take into the appointmentA liver lesion in someone with cirrhosisWhy the rules change when the liver is already scarred
Talk to us
Not sure who should look at your liver report?
Read us the impression line of your report and tell us your liver history. We will tell you who to see and how soon, and arrange it if you want. One helpline serves every CION centre.