Abdominal Masses

What is an abdominal mass?

An abdominal mass is a lump in your tummy (abdomen). Your abdomen contains many different structures including your:

• Stomach and gut (bowel).
• Liver.
• Spleen.
• Pancreas.
• Kidneys and bladder.
• Womb (uterus) and ovaries in women.
• Major blood vessels - for example, the aorta.

The exact position of the mass will help to determine what structure the mass is coming from. See the section 'What are the causes of an abdominal mass?' below.

The abdomen can be divided into nine areas:

• Just below your ribs on the right side (right upper quadrant/hypogastrium).
• Just below your ribs in the middle (epigastrium).
• Just below your ribs on the left side (left upper quadrant/hypogastrium).
• Right side of your middle abdomen (right loin/lumbar region).
• Around your tummy button (periumbilical).
• Left side of your middle abdomen (left loin/lumbar region).
• Right side of your lower abdomen (right lower quadrant/inguinal or iliac region).
• Middle of your lower abdomen (suprapubic and pelvis).
• Left side of your lower abdomen (left lower quadrant/inguinal or iliac region).

What are the symptoms of an abdominal mass?

You might feel the lump in your tummy before any other symptom, but more usually it is first felt by a doctor examining your abdomen because of a different symptom, such as abdominal pain.

Therefore, you are more likely to be aware of a mass in your abdomen because of other symptoms such as abdominal pain, diarrhoea, constipation, rectal bleeding or weight loss. A mass in your kidney may also cause blood in your urine. Any other symptoms you get will depend on exactly where the mass is and the cause of the mass.

What are the causes of an abdominal mass?

The possible cause of the lump (mass) in your tummy (abdomen) will depend on where it is in your abdomen. The following lists are examples of the more common causes of an abdominal mass in each area. A lump (swelling) that can be seen and felt over the front of the abdomen (abdominal wall) may be a skin lump or a hernia.

Right upper quadrant

• Liver: enlarged liver (hepatomegaly), liver cancer. There are many causes of an enlarged liver, including infection, heart failure, liver cancer, alcoholic liver disease and fatty liver disease.
• Gallbladder: cholecystitis, cancer of the bile duct in the liver (cholangiocarcinoma).

Epigastrium

• Stomach: for example, stomach cancer.
• Pancreas: for example, an abscess or cancer of the pancreas.

Left upper quadrant

• Spleen: enlarged spleen (splenomegaly). There are many causes of an enlarged spleen, including leukaemia, lymphoma, thalassaemia, sickle cell disease, malaria and glandular fever.
• Stomach: for example, stomach cancer.
• Pancreas: for example, an abscess or cancer of the pancreas.
• Gut (bowel): for example, colon cancer.
• Kidney: for example, kidney cancer.

Right loin

• Kidney: for example, kidney cancer.

Periumbilical

• Enlarged part of the major blood vessel (aorta): aortic aneurysm.

Left loin

• Kidney: for example, kidney cancer.

Right lower quadrant

• Bowel: for example, colon cancer.
• Kidney: for example, kidney cancer.
• Ovary: for example, cancer of the ovary.

Suprapubic and pelvis

• Bladder: for example, a distended bladder caused by a blockage preventing you from emptying your bladder - such as in prostate gland enlargement in men.
• Womb (uterus): for example, pregnancy, fibroids.
• Ovary: for example, ovarian cyst, ovarian cancer.

Left lower quadrant

• Bowel: for example, colon cancer, diverticular disease.
• Kidney: for example, kidney cancer.
• Ovary: for example, cancer of the ovary.

What tests are needed for an abdominal mass?

Initial tests will include blood tests. Further tests may include a urine test, an abdominal ultrasound scan, a CT scan or an MRI scan. Any further tests will depend on the likely underlying cause.

For women the National Institute for Health and Care Excellence (NICE) recommends that if there is evidence of fluid (called ascites) or a mass in the pelvis or abdomen, you should be referred urgently under the two-week wait rules.

It is important to remember that in most cases, no cancer will be found. For instance, fibroids are a common cause of a pelvic mass. However, it is very important that tests be done to exclude cancer as soon as possible.

What is the treatment for an abdominal mass?

The treatment will depend on the cause of the abdominal mass. There are many serious causes of an abdominal mass so you must consult a doctor as soon as you think you can feel a mass in your tummy (abdomen).