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Related Experiment Video

Updated: Nov 30, 2025

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Masquerading Hypervascular Exophytic Liver Nodule.

Kevin Kim-Jun Teh1, Albert Su-Chong Low2,3, Jason Pik-Eu Chang1,3

  • 1Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.

European Journal of Case Reports in Internal Medicine
|November 16, 2020
PubMed
Summary
This summary is machine-generated.

Patients with liver cirrhosis require surveillance for hepatocellular carcinoma (HCC). A case highlights that contrast-enhanced MRI can accurately diagnose indeterminate liver lesions, avoiding unnecessary treatment for conditions like hepatic haemangioma.

Keywords:
Exophytic liver nodulehepatic haemangiomahepatocellular carcinoma surveillance

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Area of Science:

  • Hepatology
  • Radiology
  • Oncology

Background:

  • Patients with liver cirrhosis face an elevated risk of developing hepatocellular carcinoma (HCC).
  • Routine surveillance protocols are established for early HCC detection in at-risk individuals.
  • Diagnostic algorithms guide the evaluation of liver lesions identified during surveillance.

Purpose of the Study:

  • To report a case of a hypervascular exophytic lesion indeterminate for HCC on CT imaging.
  • To emphasize the importance of accurate diagnosis for indeterminate liver lesions in cirrhotic patients.
  • To illustrate the utility of sequential contrast-enhanced MRI in differentiating HCC from other pathologies.

Main Methods:

  • Review of radiological findings for a patient with liver cirrhosis undergoing HCC surveillance.
  • Initial assessment of a liver lesion using multiphasic computed tomography (CT).
  • Subsequent evaluation with contrast-enhanced magnetic resonance imaging (MRI) including gadoxetate.

Main Results:

  • A hypervascular exophytic lesion was detected on CT imaging, initially indeterminate for HCC.
  • Contrast-enhanced MRI revealed the lesion to be an exophytic haemangioma, not HCC.
  • The accurate diagnosis via MRI obviated the need for invasive biopsy or further intervention.

Conclusions:

  • Adherence to diagnostic algorithms for indeterminate lesions during HCC surveillance is crucial.
  • Sequential contrast-enhanced MRI is valuable for diagnosing indeterminate exophytic lesions in cirrhotic patients.
  • Utilizing MRI can prevent unnecessary treatment and guide continued HCC surveillance when hepatic haemangioma is suspected.