Hepatic adenomatosis

Case contributed by Chris O'Donnell


Taking oral contraceptive pill. Incidental finding on abdominal ultrasound.

Patient Data

Age: 35 years
Gender: Female

Multiple subtle enhancing mass lesions throughout the liver in the portal venous phase


Subtle T1 and T2 hyperintense masses with poor definition on routine post-contrast imaging but clearly seen as multiple low signal lesions on delayed Primovist scanning (indicates no hepatocytes so not FNH). Liver is fatty, losing signal on the out of phase scan.

Case Discussion

Multiple enhancing mass lesions with no hepatocytes based on delayed post-contrast imaging. Differential includes metastatic disease, multifocal HCC and adenomas. The patient had 3 separate lesions biopsied and all showed adenoma. Since there are more than 10 lesions this is known as adenomatosis. It might be associated with the OCP. There is no acute hemorrhage, as can occur in this condition.

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