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[Computed tomographic detection of liver hemangiomas].
Deutsche Medizinische Wochenschrift (1946)
|November 23, 1990
Summary
A suprarenal carcinoma was initially suspected in a woman with hirsutism and elevated testosterone. Surgical removal normalized hormone levels, and liver lesions were identified as hemangiomas, correcting a diagnostic imaging error.
Area of Science:
- Endocrinology
- Radiology
- Oncology
Background:
- A 67-year-old woman presented with a eight-month history of progressive hirsutism.
- Elevated testosterone levels (2.6 micrograms/L) and 24-hour urinary cortisol excretion (160 micrograms) were noted.
Observation:
- Ultrasound revealed a large left suprarenal tumor (14 x 10 x 10 cm) and irregular liver lesions.
- Initial computed tomography (CT) suggested suprarenal carcinoma with hepatic metastases due to hypodense, non-contrast-enhancing lesions.
- Post-surgical normalization of hormonal parameters prompted re-evaluation of liver lesions.
Findings:
- Superselective hepatic angiography demonstrated liver lesions consistent with hemangiomas.
- Review of initial CT scans identified a diagnostic error attributed to incorrect contrast medium timing.
Implications:
- This case highlights the importance of optimal contrast timing in CT imaging for accurate diagnosis.
- It underscores the potential for misinterpretation of imaging findings, especially in complex cases.
- The successful surgical management of the suprarenal tumor and accurate diagnosis of liver hemangiomas are emphasized.