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      • LT, Others : PE-133 ; A case of hepatic hemangioma appearing atypical finding confirmed by dynamic MRI in patients with high risk of hepatocellular carcinoma

        ( Dong Won Park1 ),( Soo Hyung Ryu1 ),( Myung Ki Oh ),( Seong Yeon Jeong ),( Kyeong Sam Ok ),( Jae Chan Shim ),( Jin Nam Kim ),( You Sun Kim ),( Jeong Seop Moon ) 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

        Background: Hemangioma is the most common benign hepatic tumor. Many hepatic hemangiomas tend to be found incidentally, but should be differentiated from malignant tumors. We report an interesting case of hepatic hemangioma in patient who has high risks of hepatocellular carcinoma. Case: A 52-year-old woman, who was a chronic alcoholic abuser and hepatitis C virus carrier with no treatment experience, was admitted due to diarrhea. The patient had suffered from intermittent abdominal pain in the right subcostal area for recent 3 months. Also the patient had easy bruising and frequent epistaxis. She had used oral contraceptives for almost 20 years. Systolic blood pressure was 160 mmHg and diastolic blood pressure was 80 mmHg. Body temperature was normal. Physical examination revealed icteric sclerae and tenderness in right upper quadrant of the abdomen. Laboratory study showed platelet count of 31,000/ul, AST/ALT of 302/127 IU/L, and total bilirubin of 2.7 mg/dl. 3-phased contrast-enhanced abdominal computed tomography (CT) revealed a 4 cm × 4 cm sized hepatic mass involving both segment 5 and 6. Abdominal CT finding suggested hepatic hemangioma, however, typical finding of hemagioma was unclear, therefore, could not rule out the malignancy. Since she had risk factors for hepatocellular carcinoma, abdominal ultrasonography was performed for further evaluation. But abdominal ultrasonography also showed atypical finding. The confirmative diagnosis could be done by dynamic magnetic resonance imaging (MRI) using primovist®, which is an innovative liver cell-specific contrast medium. Dynamic MRI presented peripheral globular enhancement and a centripetal fill-in pattern, confirmatory findings of hepatic hemangioma, on the delayed image. The patient got relief from abdominal pain and diarrhea during admission, now is being followed-up at a general out-patient clinics. Conclusions: Hemangiomas with atypical abdominal CT and ultrasonographic findings in patients with high risks of hepatocellular carcinoma can be easily characterized with primovist-enhanced dynamic MRI.

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