Presentation
Right upper quadrant pain with an abnormal ultrasound exam.
Patient Data
Well-defined homogeneous hyperechoic mass (4.5 x 3.5 x 3 cm) in segment V of the liver. The color Doppler shows central vasculature with a "spoke-wheel" pattern of the feeding vessels.
There is a relatively well-defined ovoid mass centered on segment V of the liver with the following characteristics:
- homogeneous hypodense on non-contrast images with no fat, calcification or hemorrhage
bright homogeneous enhancement on the arterioportal phase with small central feeding arteries
becomes isodense to the normal liver parenchyma on the portal phase
- no evidence of central fibrotic scar
Case Discussion
Ultrasound with color Doppler and CT features of a hepatic mass with dynamic characteristics suggest focal nodular hyperplasia.
Hepatic focal nodular hyperplasia (FNH) is considered as a rare benign liver tumor in children, whereas it is the second most common benign liver lesion (most common is a hemangioma) in young to middle-aged adult females.
Additional contributor: C. Boukaaba, MD