Hepatic adenoma

Case contributed by Dr Mohammad Taghi Niknejad

Presentation

Abdominal pain.

Patient Data

Age: 45 years
Gender: Female
CT

The hepatic attenuation value is less than of the spleen, suggesting fatty liver disease. A 59×47mm isodense mass is present at caudate lobe of the liver.  After contrast media injection, the mass shows inhomogeneous enhancement more than surrounding parenchyma on all phases, without washed out. 
The gallbladder is not seen at anatomical location due to prior resection.
Degenerative changes as osteophytosis are seen at the lumbar spine.

MRI

The signal intensity of liver parenchyma shows heterogeneous drop out on opposed phase. GRET1WI in favor of fat infiltration.
There is a 59x47mm mass at caudate lobe of liver which is low signal on T1WI and slightly hypersignal on T2WI. Some part of mass shows signal dropout on opposed phase GRET1WI. After contrast injection the mass shows arterial dominant phases hyperenhancement and is iso intense on delayed phases.
Gallbladder is not seen (prior surgery). CBD show mild dilatation which could be related to post cholecystectomy changes.
A 6mm cortical cyst is seen at left kidney.

Case Discussion

Enhancement pattern of liver mass is compatible with benign hypovascular lesions, and hepatic adenoma is most likely diagnosis.

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