Case 234: Solitary Fibrous Tumor

Diagnostic Category:

Clinical Presentation:

45 year old woman with increasing epigastric pain.

CT: Pseudocapsule, typical fibrotic enhancement, in steatosis

Imaging Findings:

CT shows an unusual presentation of a benign solid fibrous tumor in a fatty liver in segment 4: ring enhancing pseudocapsule on arterial and portal venous phase is unusual, while progressive enhancement centrally, which is higher density on the equilibrium images than blood pool (compare to aorta and IVC) are typical for a fibrotic tumor of benign or malignant origin. This feature is one the enhancement pattern that distinguish fibrotic tumors from hemangiomas.

Note the steatosis is pronounced in the left lobe. After percutaneous biopsy the tumor was resected via left hemihepatectomy.