Problems in the imaging diagnosis of hepatoma

Two problem cases in the imaging diagnosis of hepatoma are reported. In both, a defect on the standard liver scan showed preferential gallium uptake. Ultrasound findings for a mass lesion were inconsistently present or absent. However, in the given clinical setting, a diagnosis of hepatoma was made. The microscopic changes suggested that the poor ultrasound demonstration of the tumors was due to marked fibrosis of the liver both outside and inside the tumor.