Hepatic adenomatosis

Case contributed by Dr Chris O'Donnell

Presentation

Taking oral contraceptive pill. Incidental finding on abdominal ultrasound.

Patient Data

Age: 35 years
Gender: Female
CT

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

MRI

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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Case information

rID: 26904
Published: 13th Jan 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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