Thrombosed hepatic cavernous haemangioma

Case contributed by Dr Chris O'Donnell

Presentation

Acute right upper quadrant pain. US shows an echogenic mass in the liver. MRI for clarification

Patient Data

Age: 45
Gender: Male
Modality: MRI

Typical cavernous haemangiona of the liver ie bright on T2 with intense peripheral enhancement on the arterial phase contrast-enhanced dynamic with "filling in" over time.  The upper portion, however, contains an atypical T1 hyperintense, mixed T2 signal mass that does not enhance.  This is in keeping with subacute haemorrhage (methaemoglobin)

Modality: MRI

Follow-up MRI shows reduction in size of the intracavernous thrombus.

Case Discussion

Spontaneous thrombosis of cavernous haemangioma of the liver is rare but should not confused with sclerosing or hyalinized haemangioma where the vascular channels are obliterated with fibrous tissue, not T1 hyperintense material (methaemoglobin) as in this case.

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Case Information

rID: 43896
Case created: 28th Mar 2016
Last edited: 20th Sep 2016
Inclusion in quiz mode: Included

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