Hepatic adenoma

Case contributed by Andressa Wiltgen
Diagnosis almost certain


Routine ultrasound.

Patient Data

Age: 35 years
Gender: Female



Solitary, well demarked, predominantly hypoechogenic mass. 



The images show a mass, well demarked, in the segments VII/VIII, with an intermediary signal on T2,  showing early enhancement after contrast injection, becoming isointense on the delayed acquisition. 

Case Discussion

Most hepatic adenomas occur in young to middle-aged women with exogenous estrogen use. Other risk factors are fatty liver disease, abnormal hepatic blood inflow (Abernathy syndrome) or abnormal blood outflow (Budd Chiari syndrome), genetic metabolic disease, and McCune-Albright Syndrome.  
Ultrasound images shows usually a well-demarcated mass, with variable echogenicity. In MR images, most adenomas are bright on T1 weighted series, but the features can be variable (iso-, hyper-, or hypointense).
Most patients are asymptomatic and the biopsy is not recommended as a routine. Images examination can be performed for evaluating hepatic adenomas and their possible complications. 

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