Case 274:   Metastasis - Salivary Gland Cancer

Diagnostic Category:

Clinical Presentation:

62 year old woman with salivary gland cancer, hypodense liver lesions seen on staging CT.

MR: Pseudohepatospecific enhancement with Gd-EOB-DTPA

Imaging Findings:

MR shows multiple metastases that are hypointense on T1 and hyperintense on T2. They are relatively hypovascular on portal venous phase. Note the restricted diffusion on DWI, which is typical for metastases.

There is marked 'pseudohepatospecific' enhancement peripherally within the masses 20 minutes after Gd-EOB-DTPA administration, typical for fibrotic components of metastases.

This liver demonstrates the "right posterior hepatic notch sign", which has been reported to be a useful indicator for cirrhosis; on this patient however with no cirrhosis or pseudocirrhosis the notch represents a variant of hepatic lobulation.