A 62-year-old woman was incidentally noted to have a subtle low attenuation lesion in the periphery of the right lobe of the liver on a CT scan done for other reasons. The enhanced image shows the lesion more clearly. She had a history of oral hormone therapy. CT guided fine needle aspiration of the lesion was non-specific, with no malignant cells identified. The patient was taken to the operating room for elective resection of the lesion with a presumed diagnosis of hepatic adenoma. The indication for surgery was both diagnostic to rule out malignancy and prophylactic to eliminate the possibility of rupture and hemorrhage.
An out-of-phase T1 weighted MRI image helps pick up the lesion, since the lesion contains fat, and the water and fat cancel each other out in the out-of--phase image.
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