Liver lesions with hepatic capsular retraction

Area of Science:

• Radiology
• Hepatology
• Oncology

Background:

• Hepatic capsular retraction presents a diagnostic challenge due to its varied causes.
• Common etiologies include liver cirrhosis, cholangiocarcinoma, and treated liver tumors.
• Less frequent causes encompass inflammatory conditions, vascular tumors, and trauma.

Purpose of the Study:

• To review the spectrum of benign and malignant etiologies of hepatic capsular retraction.
• To highlight computed tomographic findings aiding in the diagnosis of specific hepatic lesions.
• To emphasize that capsular retraction is not exclusively a sign of malignancy.

Main Methods:

• Review of imaging findings associated with hepatic capsular retraction.
• Correlation of imaging features with histopathological diagnoses.
• Analysis of factors contributing to subcapsular pathology.

Main Results:

• Identified common causes: fibrosis in cirrhosis, cholangiocarcinoma, treated hepatocellular carcinoma, metastases, and lymphoma.
• Noted less common causes: primary sclerosing cholangitis, epithelioid hemangioendothelioma, hemangioma, solitary fibrous tumor, and inflammatory pseudotumor.
• Highlighted iatrogenic and non-iatrogenic trauma as potential causes.

Conclusions:

• Hepatic capsular retraction is associated with a wide range of conditions, necessitating familiarity with their imaging characteristics.
• Accurate diagnosis is crucial to guide therapeutic strategies and avoid misinterpretation as solely malignant.
• Understanding the unique vascular and anatomical factors of the hepatic capsular region aids in diagnosing diverse pathologies.