The appearances of multiple biliary hamartomas of the liver (von Meyenberg complexes) on computed tomography

Computed tomography is well established in the management of patients with malignant disease, both as a staging procedure before initiation of treatment and in follow up. The presence of unsuspected metastases may affect the decision to perform surgery on the primary tumour and may alter the management of suspected recurrent tumour. Two cases are presented of patients with primary carcinoma whose computed tomography images showed multiple focal hepatic lesions suggestive of metastases. However multiple biliary hamartomas were found on histology, in one case by biopsy and in the other at post mortem. The differential diagnosis and significance of multiple liver defects on computed tomography is considered.