Presentation
Referred patient with reported incidental relatively hypoechoic lesion on ultrasound for CT assessment? focal fatty sparing? hepatic adenoma. The patient is on oral contraceptive pills.
Patient Data
The liver is enlarged, measuring 20 cm in MCL, with a diffusely decreased tissue density (7 HU), reflecting diffuse steatosis.
A rounded homogeneous focal hepatic lesion is seen at segment VII, measuring 4.7 x 5 x 4 cm in AP, SS, and CC dimensions, with peripheral beaded enhancement in porto-venous and early delayed phases and progressive centripetal irregular enhancement in delayed phase, consistent with hepatic hemangioma.
A small, enhancing hepatic lesion is also noted in segment VII (0.7 cm), also considered a small hemangioma.
Case Discussion
The enhancing pattern is suggestive of a large hepatic hemangioma in segment VII and another adjacent tiny one on the background of an enlarged liver with diffuse steatosis.
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