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Radiological reasoning: incidentally discovered liver mass
Michelle M Bittle1, Felix S Chew
1Department of Radiology, University of Washington, Harborview Medical Center, 325 Ninth Ave., Box 359728, Seattle, WA 98104-2499, USA. mbittle@u.washington.edu
AJR. American Journal of Roentgenology
|May 23, 2006
Summary
A hip fracture patient incidentally developed hepatocellular carcinoma (HCC). Imaging revealed a liver mass with characteristic enhancement and washout patterns, confirmed by pathology.
Area of Science:
- Hepatobiliary imaging
- Abdominal radiology
- Oncology
Background:
- Hip fractures are common injuries requiring hospitalization.
- Incidental findings during imaging evaluations necessitate careful assessment.
- Hepatocellular carcinoma (HCC) is a primary liver malignancy.
Observation:
- A 49-year-old woman with a hip fracture developed abdominal pain.
- Sonography revealed a hypoechoic liver mass.
- Multiphase CT demonstrated a hepatic mass with specific enhancement characteristics.
Findings:
- The hepatic mass exhibited brisk arterial phase enhancement.
- Rapid washout was observed on the portal venous phase.
- Delayed phase imaging showed hypodensity, consistent with HCC.
Implications:
- Incidental liver lesions require thorough investigation.
- Multiphase CT is crucial for characterizing hepatic masses.
- Early diagnosis of hepatocellular carcinoma improves management outcomes.