Vanishing haemangiomas due to steatosis

Case contributed by Bálint Botz
Diagnosis almost certain

Presentation

Screening US. Two small echogenic liver lesions known from last scan, two years earlier, confirmed as haemangiomas.

Patient Data

Age: 40 years
Gender: Female
ultrasound

The two small, stable lesions situated in segment 2 and 6 can be identified, although with much difficulty, even though the background echogenicity of the liver has increased only subtly due to steatosis. 

2 years earlier examination

ultrasound

Note that lesions are far more easily seen on the earlier images (same transducer and preset).

Case Discussion

Even very subtle increase in the echogenicity of the liver can obscure echogenic lesions such as typical haemangiomas. If the steatosis progresses further the lesions can "reappear" but as hypoechogenic lesions on the background of the fatty liver.

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