Presentation
Ultrasound performed for mildly elevated liver enzymes.
Patient Data
Age: 65 years
Gender: Male
From the case:
Geographic steatosis mimicking a mass
![](https://prod-images-static.radiopaedia.org/images/49063780/c533987a61a001cd086cd9116204f5_thumb.jpeg)
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Irregular area of hypoechogenicity in the liver without mass effect, likely geographic steatosis.. Recommend MRI for confirmation.
From the case:
Geographic steatosis mimicking a mass
![](https://prod-images-static.radiopaedia.org/images/49063804/7a8023842cccfb836a3ac4355fb970_thumb.jpeg)
![](https://prod-images-static.radiopaedia.org/images/49063805/4e0f97859866a4b51edffb2eb95ce3_thumb.jpeg)
![](https://prod-images-static.radiopaedia.org/images/49063806/f3287c76b5bd7bc4f66a3c9b161764_thumb.jpeg)
![](https://prod-images-static.radiopaedia.org/images/49063814/f8fe8207b2d06a3db5fef2624fbbaf_thumb.jpeg)
![](https://prod-images-static.radiopaedia.org/images/49063829/34c760c3a50d3a3c59d87fc8817746_thumb.jpeg)
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MRI confirms the sonogram findings of no mass effect and focal fatty sparing appearing as a pseudolesion.
Case Discussion
Look for mass effect and any vascular compromise when viewing a sonogram for lesion vs pseudolesion. MRI is useful to assess whether there is truly a mass or mass effect. In this case, the patient can be told to undertake lifestyle changes for steatosis and that no further workup is necessary.