Case 234: Solitary Fibrous Tumor

Diagnostic Category:

Clinical Presentation:

45 year old woman with increasing epigastric pain.

MR: Fibrotic enhancement, hypointense on T2

Imaging Findings:

MR shows a hypovascular mass in the left lobe with mild susceptibility artifacts on in-phase images, very hypointense T2 signal and progressive fibrotic enhancement on the equilibrium phase after 5 minutes with Gd-BOPTA.

On the hepatobiliary phase after one hour the liver parenchyma shows increased intracellular Gd-BOPTA uptake, while the mass shows hypointensity, just minimally higher than that of blood pool (compare to aorta and IVC). Biopsy and resection revealed benign solitary fibrous tumor, a very firm and dense neoplasm, which may contain traces of calcium, causing the susceptibility artifacts on the in-phase image and markedly low T2 signal. 

Note that hepatic parenchyma is not steatotic on MR, in contrast to its appearance on the CT three months before.