Presentation
Right hypochondrial pain with liver mass discovered on ultrasound examination.
Patient Data
A large exophytic right liver lobe hypervascular lesion is seen showing intense enhancement in the late arterial phase with portal venous washout and fading, becoming difficult to detect. Multiple branching central hypodense lines showing no arterial enhancement with delayed enhancement making them isodense to the surrounding tissues. These lines represent the central scar. Prominent feeding vessels are seen.
Case Discussion
Focal nodular hyperplasia is the second most common benign hepatic lesion after hemangioma. It has a hypervascular enhancement pattern on a triphasic study with a characteristic central scar. The main differential diagnosis is fibrolamellar hepatocellular carcinoma.
Case courtesy of Dr. Abdelrahman Omar.
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