Presentation
Known case of insulinoma, post irreversible electroporation x 2 times. Follow-up study.
Patient Data
Artifacts from the gastroduodenal artery coils. An arterial enhancing lesion in the neck of the pancreas behind the coils (known insulinoma). The pancreatic duct is dilated (0.8 cm).
Fat density area is seen in the segment IVB/V of the liver (along the porta hepatis); vessels traverse through it, suggestive of an area of focal fat deposition. Few cysts in the liver and spleen.
Case Discussion
Focal hepatic steatosis usually occurs in the peri-ligamentous and periportal locations, and it does not cause mass effect and distortion of the traversing vessels through it. It can be mistaken for a focal neoplasm (particularly in ultrasound and CT scans). MRI is the imaging modality of choice in cases where the diagnosis is less certain, showing increased T1 signal and signal drop-out on opposed-phase imaging.
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