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Benign metastasizing pleomorphic adenoma in liver mimicking synchronic metastatic disease from colorectal cancer: a case report with emphasis on imaging findings.

Young VS, Viktil E, Løberg EM, Enden T - Acta Radiol Open (2015)

Bottom Line: Pleomorphic adenoma of the parotid gland with metastases to the liver is a rare etiology of focal liver lesions, and there are no described pathognomonic imaging features.We report a patient who presented with a newly diagnosed rectal cancer and multiple cystic liver lesions suspicious of mucinous synchronous liver metastases.Following chemotherapy no reduction in the number or size of the liver lesions was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Oslo University Hospital, Oslo, Norway.

ABSTRACT
Pleomorphic adenoma of the parotid gland with metastases to the liver is a rare etiology of focal liver lesions, and there are no described pathognomonic imaging features. We report a patient who presented with a newly diagnosed rectal cancer and multiple cystic liver lesions suspicious of mucinous synchronous liver metastases. Following chemotherapy no reduction in the number or size of the liver lesions was observed. The patient was re-evaluated and a biopsy of a lesion was performed. The specimen showed a metastasis from a pleomorphic adenoma of the parotid gland for which the patient had been treated 20 years earlier. The case illustrates how a thorough medical history can be crucial when a standard diagnostic imaging workup for colorectal cancer metastases is uncertain, and how a biopsy, though regarded as contraindicated due to the risk of tumor cell dissemination, can be required to secure a correct diagnosis.

No MeSH data available.


Related in: MedlinePlus

Ultrasound of the liver with and without contrast. (a) Grayscale ultrasound showing a hypodense lesion in segment IV with an irregular border and a posterior echo-shadow indicating fluid content. (b) Contrast-enhanced ultrasound of the same lesion demonstrated no enhancement or washout in the arterial (not shown) or portal phase.
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fig2-2058460115594199: Ultrasound of the liver with and without contrast. (a) Grayscale ultrasound showing a hypodense lesion in segment IV with an irregular border and a posterior echo-shadow indicating fluid content. (b) Contrast-enhanced ultrasound of the same lesion demonstrated no enhancement or washout in the arterial (not shown) or portal phase.

Mentions: An US of the liver with and without intravenous contrast (SonoVue®) showed hypoechogenic, lobulated, and/or oval lesions with slightly irregular borders and with posterior echo enhancement indicating fluid content (Fig. 2a). Except for the smallest lesions, central septations were displayed. No convincing contrast enhancement was observed (Fig. 2b). The lesions were interpreted as “complicated cysts” or metastases with necrosis or a mucinous content, and to be in line with the CT findings.Fig. 2.


Benign metastasizing pleomorphic adenoma in liver mimicking synchronic metastatic disease from colorectal cancer: a case report with emphasis on imaging findings.

Young VS, Viktil E, Løberg EM, Enden T - Acta Radiol Open (2015)

Ultrasound of the liver with and without contrast. (a) Grayscale ultrasound showing a hypodense lesion in segment IV with an irregular border and a posterior echo-shadow indicating fluid content. (b) Contrast-enhanced ultrasound of the same lesion demonstrated no enhancement or washout in the arterial (not shown) or portal phase.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4548729&req=5

fig2-2058460115594199: Ultrasound of the liver with and without contrast. (a) Grayscale ultrasound showing a hypodense lesion in segment IV with an irregular border and a posterior echo-shadow indicating fluid content. (b) Contrast-enhanced ultrasound of the same lesion demonstrated no enhancement or washout in the arterial (not shown) or portal phase.
Mentions: An US of the liver with and without intravenous contrast (SonoVue®) showed hypoechogenic, lobulated, and/or oval lesions with slightly irregular borders and with posterior echo enhancement indicating fluid content (Fig. 2a). Except for the smallest lesions, central septations were displayed. No convincing contrast enhancement was observed (Fig. 2b). The lesions were interpreted as “complicated cysts” or metastases with necrosis or a mucinous content, and to be in line with the CT findings.Fig. 2.

Bottom Line: Pleomorphic adenoma of the parotid gland with metastases to the liver is a rare etiology of focal liver lesions, and there are no described pathognomonic imaging features.We report a patient who presented with a newly diagnosed rectal cancer and multiple cystic liver lesions suspicious of mucinous synchronous liver metastases.Following chemotherapy no reduction in the number or size of the liver lesions was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Oslo University Hospital, Oslo, Norway.

ABSTRACT
Pleomorphic adenoma of the parotid gland with metastases to the liver is a rare etiology of focal liver lesions, and there are no described pathognomonic imaging features. We report a patient who presented with a newly diagnosed rectal cancer and multiple cystic liver lesions suspicious of mucinous synchronous liver metastases. Following chemotherapy no reduction in the number or size of the liver lesions was observed. The patient was re-evaluated and a biopsy of a lesion was performed. The specimen showed a metastasis from a pleomorphic adenoma of the parotid gland for which the patient had been treated 20 years earlier. The case illustrates how a thorough medical history can be crucial when a standard diagnostic imaging workup for colorectal cancer metastases is uncertain, and how a biopsy, though regarded as contraindicated due to the risk of tumor cell dissemination, can be required to secure a correct diagnosis.

No MeSH data available.


Related in: MedlinePlus