Case 306

Area of Science:

• Hepatobiliary Imaging
• Interventional Radiology
• Diagnostic Oncology

Background:

• A 61-year-old female presented with an incidentally discovered porta hepatis mass.
• Past medical history includes pulmonary embolism, pulmonary abscess, and hypothyroidism treated with levothyroxine.
• No history of liver disease, prior malignancy, or trauma.

Observation:

• Physical examination and laboratory tests, including tumor markers (CEA, CA 19-9), were unremarkable.
• Imaging included unenhanced and multiphasic contrast-enhanced CT, with axial and coronal maximum intensity projection reconstructions.
• Endoscopic ultrasound-guided fine-needle biopsy and whole-body iodine 131 scintigraphy were performed.

Findings:

• CT imaging revealed a mass in the porta hepatis, raising concerns for malignancy.
• Endoscopic ultrasound-guided biopsy was performed for definitive characterization.
• Iodine 131 scintigraphy was utilized as part of the diagnostic workup.

Implications:

• This case highlights the diagnostic challenges and multidisciplinary approach required for incidentally discovered liver region masses.
• Accurate characterization through advanced imaging and biopsy is crucial for appropriate patient management.
• The study underscores the importance of integrating various diagnostic modalities for complex hepatobiliary presentations.