Presentation
New diagnosis of breast cancer. Liver lesions on staging CT. For ultrasound +/- biopsy
Patient Data
There is a lesion in segment 7 that demonstrates progressive peripheral nodular enhacement
The liver is of normal echo intensity. There is no evidence of liver parenchymal disease. Within segment 6/7 of the liver in a subdiaphragmatic position, there is a sharply circumscribed echogenic lesion measuring 3.6 cm. More anteriorly and inferiorly (segment 5) within the right lobe of liver, there is a second sharply circumscribed echogenic lesion measuring 1.2 cm.
Review of recent outside CT imaging (19/9/14) demonstrates a segment 7 lesion liver lesion with progressive peripheral nodular enhancement. A second small low density lesion in segment 6 is seen on portal venous phase only.
The overall findings are consistent with liver hemangiomas. There is no evidence of a metastasis on ultrasound.
Not for biopsy. Recommend correlation with report of outside CT.
Case Discussion
The liver lesion in segment 6/7 showed peripheral nodular enhancement with progressive fill in during the portal venous and delayed phases, which is consistent with a typical hepatic hemangioma.
As hemangiomas are benign and highly vascular, this lesion was deemed unsuitable for biopsy.