Case 9: Adenoma

Diagnostic Category:

Benign Neoplasm

Clinical Presentation:

45 year old woman on oral contraceptive pills (OCP) presents with a palpable hepatic mass.

DDx

CT: Adenomatosis in steatosis

Unenhanced

Arterial

Portal Venous

Equilibrium

Arterial

Portal Venous

Imaging Findings:

Multiphase CT reveals multiple hepatic adenomas that are subtly heterogeneously hypervascular without washout. No evidence of cirrhosis, but steatosis. Core biopsy of a smaller mass suggested hepatic adenoma, less likely well-differentiated hepatocellular carcinoma. After discontinuing OCP's, the masses decreased in size over 7 years of follow up (see MR).

The last image shows a small cavernous hemangioma in segment 7. Hemangiomas commonly coexist with hepatic adenomas.