September 2012

Focal liver lesion

Clinical Info

Pain in the right upper abdomen

Ultrasound Images & Clips

Focal liver lesion

There is an inhomogeneous focal liver lesion
There is an inhomogeneous focal liver lesion
Another image of the same lesion. There are hypoechoic and anechoic parts
Another image of the same lesion. There are hypoechoic and anechoic parts
There is peripheral vascularity
There is peripheral vascularity
There is also vascularity within the lesion. When a mass lesion in the liver is found in a young female patient one should think about a hepatic adenoma. Always inform about the use of oral contraceptives. In this case the patient uses oral contraceptives
There is also vascularity within the lesion. When a mass lesion in the liver is found in a young female patient one should think about a hepatic adenoma. Always inform about the use of oral contraceptives. In this case the patient uses oral contraceptives
CT scan art. phase
CT scan art. phase
CT scan venous phase The diagnosis hemorrhage in a hepatic adenoma was confirmed
CT scan venous phase The diagnosis hemorrhage in a hepatic adenoma was confirmed
CT scan of the same patient some time later after stopping the oral contraceptives. The lesion is smaller
CT scan of the same patient some time later after stopping the oral contraceptives. The lesion is smaller
Ultrasound scan of a 32 year old female patient also using oral contraceptives. She had severe pain in the right abdomen
Ultrasound scan of a 32 year old female patient also using oral contraceptives. She had severe pain in the right abdomen
Another image of the same patient. The liver is very inhomogeneous and there is a perihepatic hematoma.
Another image of the same patient. The liver is very inhomogeneous and there is a perihepatic hematoma.
There is a large perihepatic hematoma. In this case again our initial diagnosis was hemorrhage of a hepatic adenoma. The patient went inmediately to the CT scan
There is a large perihepatic hematoma. In this case again our initial diagnosis was hemorrhage of a hepatic adenoma. The patient went inmediately to the CT scan
CT without contrast (The contrast in the gallbladder was the result of an ERCP the previous day because the gastroenterologist thought she had bile duct stones)
CT art. phase
CT venous phase
CT late phase Again the diagnosis hemorrhage in a hepatic adenoma was confirmed. There are several adenomas. The patient was treated in a university center
Ultrasound scan of a 36 year old patient with slightly hypoechoic but homogeneous mass lesion also using oral contraceptives. The lesion was an  incidental findings.
Ultrasound scan of a 36 year old patient with slightly hypoechoic but homogeneous mass lesion also using oral contraceptives. The lesion was an incidental findings.
Another image of the large lesion
Another image of the large lesion
The lesion is vascularized
The lesion is vascularized
Another image of the large lesion
Another image of the large lesion
CT without contrast
CT art phase
CT Late phase In this case the adenoma was an incidental finding in an asymptomatic patient without a hemorrhage

Conclusion

When a liver lesion is found in a young female patient who uses oral contraceptives always think of a liver adenoma. Liver adenomas can cause a hemorrhage that can be minor as in the first patient or very severe as in the second case.


Details

  • Sex: Female
  • Age: 22

Created with

  • Hitachi Ultrasound System