Hepatic adenoma

Case contributed by Mohamed Saber


Right upper quadrant pain

Patient Data

Age: 35 years
Gender: Female

The ultrasound study revealed an incidental left hepatic lobe subcapsular relatively hypoechogenic mass. Gallbladder stone is noted presumed to be the cause of patient's complain


CT study revealed a left hepatic lobe well-defined ovoid lesion elicits low attenuation in the pre-contrast study. It elicits early enhancement in the late arterial phase with rapid contrast washout in the Porto-venous and delayed phases. Incidental post-cholecystectomy surgical clips


In the MRI study, the lesion is hyperintense in T2WI relative to normal hepatic parenchyma and suppressed in T2 fat sat. In T1 "in phase", the lesion is isointense to hepatic parenchyma with a significant signal drop in T1 "out of phase" denoting intracellular lipid. It elicits early enhancement in the arterial phase with contrast washout in the portal phase

Case Discussion

Here is a case of fat-containing hepatic adenoma in a middle-aged female patient receiving contraceptive pills. The enhancement pattern is similar to other hypervascular lesions (HCC, FNH, metastases), however, the incidental finding,  presence of intra lesion fat, and history of pills intake, all favor the possibility of adenoma. The patient subjected to a follow up with a stationary course of this lesion developed no increased size or spontaneous rupture

Ultrasound contribution by Dr. Shaimaa Hussien

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