EURORAD ESR

Case 15034

Neuroendocrine Liver Metastases Mimicking Haemangiomas

Author(s)
Henrique Donato, Francisco Pereira da Silva, Pedro Belo-Oliveira, Filipe Caseiro-Alves

University Hospital of Coimbra, Faculty of Medicine of Coimbra, Medical Imaging; Quinta de Voimarães, lote 7, 7ºesq 3000-377 Coimbra, Portugal; Email:donato.henrique@gmail.com
 
Patient
male, 72 year(s)
 
 
  • Figure 1
    First abdominal ultrasound
     

    On the first abdominal ultrasound, a 25mm hyperechoic nodule was detected in segment 8 of the liver, with regular borders but a small hypoechoic area.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    A second hyperechoic nodule was detected in segment 6 with 16mm, regular borders and homogeneous echostructure. A right renal cyst with internal septum is also shown.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    Control abdominal ultrasound
     

    On the abdominal ultrasound performed 10 months later, the larger hyperechoic nodule in segment 8 remained stable, with 25mm and the hypoechoic area.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    The nodule in segment 6 showed a slight increase, measuring 20mm, remaining homogeneously hyperechoic with regular borders.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    An additional hyperechoic lesion was observed in segment 4b, previously unmentioned, with 14mm.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 3
    Contrast-enhanced ultrasound
     

    Assessment of the lesion located in segment 8 demonstrates rapid centripetal enhancement in the arterial phase (arrow).

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;

    Assessment of the lesion located in segment 8 demonstrates rapid centripetal enhancement in the arterial phase (arrow).

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;

    Washout was observed early on (arrow), starting about 30 seconds after injection.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;

    Washout was observed early on (arrow), starting about 30 seconds after injection.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Contrast agent-intravenous; Special Focus: Neoplasia;
     
     
  • Figure 4
    Abdominal CT
     

    On the precontrast CT scan, a spiculated mass in the mesenteric fat of the right lower quadrant was detected, with discrete calcifications (arrow).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Coronal reformat of the portal venous phase scan, showing the spiculated mesenteric mass (arrow) immediately cranial to the terminal ileum. No other mesenteric lesions or retroperitoneal lymphadenopathies were detected.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    The adjacent terminal ileum presented slight hyperenhancement in the arterial phase (arrow), compared to the precontrast scan.

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
On the first abdominal ultrasound, a 25mm hyperechoic nodule was detected in segment 8 of the liver, with regular borders but a small hypoechoic area.
 
A second hyperechoic nodule was detected in segment 6 with 16mm, regular borders and homogeneous echostructure. A right renal cyst with internal septum is also shown.
 
On the abdominal ultrasound performed 10 months later, the larger hyperechoic nodule in segment 8 remained stable, with 25mm and the hypoechoic area.
 
The nodule in segment 6 showed a slight increase, measuring 20mm, remaining homogeneously hyperechoic with regular borders.
 
An additional hyperechoic lesion was observed in segment 4b, previously unmentioned, with 14mm.
 
Assessment of the lesion located in segment 8 demonstrates rapid centripetal enhancement in the arterial phase (arrow).
 
Assessment of the lesion located in segment 8 demonstrates rapid centripetal enhancement in the arterial phase (arrow).
 
Washout was observed early on (arrow), starting about 30 seconds after injection.
 
Washout was observed early on (arrow), starting about 30 seconds after injection.
 
On the precontrast CT scan, a spiculated mass in the mesenteric fat of the right lower quadrant was detected, with discrete calcifications (arrow).
 
Coronal reformat of the portal venous phase scan, showing the spiculated mesenteric mass (arrow) immediately cranial to the terminal ileum. No other mesenteric lesions or retroperitoneal lymphadenopathies were detected.
 
The adjacent terminal ileum presented slight hyperenhancement in the arterial phase (arrow), compared to the precontrast scan.
 
 
 
Home Search Sections Teaching Cases History FAQ Case Archives Contact Login Disclaimer Imprint Switch to MOBILE version
View desktop version