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Exophytic benign and malignant hepatic tumors: CT imaging features.

Kim HJ, Lee DH, Lim JW, Ko YT, Kim KW - Korean J Radiol (2008 Jan-Feb)

Bottom Line: The beak sign and the feeding artery of a tumor are useful diagnostic indicators of exophytic hepatic tumors.Two- or three-dimensional reformation images are also helpful for diagnosis.The CT features of exophytic hepatic tumors are similar to those of the usual intrahepatic tumors except for their location.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Kyung Hee University Medical Center, Dongdaemun-Gu, Seoul, Korea. radhjkim@khu.ac.kr

ABSTRACT
Our objective is to describe the CT features of exophytic hepatic tumors those may pose a diagnostic challenge because of the uncertainty of tumor origin. The beak sign and the feeding artery of a tumor are useful diagnostic indicators of exophytic hepatic tumors. Two- or three-dimensional reformation images are also helpful for diagnosis. The CT features of exophytic hepatic tumors are similar to those of the usual intrahepatic tumors except for their location.

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A 23-year-old woman with an exophytic hepatocelluar adenoma.A. A contrast-enhanced CT scan during hepatic arterial phase shows a heterogeneous and mild high-density mass (arrows), below the right lobe. Prominent subcapsular vessels are noted (arrowhead). The beak sign is not definite on serial axial images (not shown).B. On a contrast-enhanced CT scan during portal venous phase, the mass (arrows) shows persistent heterogeneity and a slightly decreased density.C. An oblique coronal maximum-intensity-projection image during hepatic arterial phase shows a large branch (arrowhead) from the right hepatic artery supplying this mass (arrows).
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Figure 5: A 23-year-old woman with an exophytic hepatocelluar adenoma.A. A contrast-enhanced CT scan during hepatic arterial phase shows a heterogeneous and mild high-density mass (arrows), below the right lobe. Prominent subcapsular vessels are noted (arrowhead). The beak sign is not definite on serial axial images (not shown).B. On a contrast-enhanced CT scan during portal venous phase, the mass (arrows) shows persistent heterogeneity and a slightly decreased density.C. An oblique coronal maximum-intensity-projection image during hepatic arterial phase shows a large branch (arrowhead) from the right hepatic artery supplying this mass (arrows).

Mentions: A hepatocellular adenoma is a rare benign tumor that is usually encountered in young women that use oral contraceptives. Macroscopically, a hepatocellular adenoma is a spherical, sometimes pedunculated, well demarcated, often encapsulated solitary liver tumor (7). Exophytic growth or distortion of the hepatic contour was present in 25% of cases (8). Angiographically, a hepatocellular adenoma presents as a hypervascular mass with centripetal flow (9). On non-enhanced and enhanced CT images, adenomas are usually heterogeneous because of fatty infiltration, hemorrhage, and necrosis (7). Therefore, identification of the feeding artery and the heterogeneous attenuation on CT may provide clues for the diagnosis of an exophytic hepatic adenoma (Fig. 5).


Exophytic benign and malignant hepatic tumors: CT imaging features.

Kim HJ, Lee DH, Lim JW, Ko YT, Kim KW - Korean J Radiol (2008 Jan-Feb)

A 23-year-old woman with an exophytic hepatocelluar adenoma.A. A contrast-enhanced CT scan during hepatic arterial phase shows a heterogeneous and mild high-density mass (arrows), below the right lobe. Prominent subcapsular vessels are noted (arrowhead). The beak sign is not definite on serial axial images (not shown).B. On a contrast-enhanced CT scan during portal venous phase, the mass (arrows) shows persistent heterogeneity and a slightly decreased density.C. An oblique coronal maximum-intensity-projection image during hepatic arterial phase shows a large branch (arrowhead) from the right hepatic artery supplying this mass (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627168&req=5

Figure 5: A 23-year-old woman with an exophytic hepatocelluar adenoma.A. A contrast-enhanced CT scan during hepatic arterial phase shows a heterogeneous and mild high-density mass (arrows), below the right lobe. Prominent subcapsular vessels are noted (arrowhead). The beak sign is not definite on serial axial images (not shown).B. On a contrast-enhanced CT scan during portal venous phase, the mass (arrows) shows persistent heterogeneity and a slightly decreased density.C. An oblique coronal maximum-intensity-projection image during hepatic arterial phase shows a large branch (arrowhead) from the right hepatic artery supplying this mass (arrows).
Mentions: A hepatocellular adenoma is a rare benign tumor that is usually encountered in young women that use oral contraceptives. Macroscopically, a hepatocellular adenoma is a spherical, sometimes pedunculated, well demarcated, often encapsulated solitary liver tumor (7). Exophytic growth or distortion of the hepatic contour was present in 25% of cases (8). Angiographically, a hepatocellular adenoma presents as a hypervascular mass with centripetal flow (9). On non-enhanced and enhanced CT images, adenomas are usually heterogeneous because of fatty infiltration, hemorrhage, and necrosis (7). Therefore, identification of the feeding artery and the heterogeneous attenuation on CT may provide clues for the diagnosis of an exophytic hepatic adenoma (Fig. 5).

Bottom Line: The beak sign and the feeding artery of a tumor are useful diagnostic indicators of exophytic hepatic tumors.Two- or three-dimensional reformation images are also helpful for diagnosis.The CT features of exophytic hepatic tumors are similar to those of the usual intrahepatic tumors except for their location.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Kyung Hee University Medical Center, Dongdaemun-Gu, Seoul, Korea. radhjkim@khu.ac.kr

ABSTRACT
Our objective is to describe the CT features of exophytic hepatic tumors those may pose a diagnostic challenge because of the uncertainty of tumor origin. The beak sign and the feeding artery of a tumor are useful diagnostic indicators of exophytic hepatic tumors. Two- or three-dimensional reformation images are also helpful for diagnosis. The CT features of exophytic hepatic tumors are similar to those of the usual intrahepatic tumors except for their location.

Show MeSH
Related in: MedlinePlus