PMC4210452_01
Primary hepatic carcinoid tumor in 70-year-old male. An axial T2-weighted MR image (a) shows the hepatic mass, which included multiple cystic areas with shading. An axial T1-weighted MR image (b) shows some hyperintense cystic areas in the hepatic mass. Axial fat-suppressed dynamic MR images with Gd-EOB-DTPA show the prolonged enhancement of solid areas and the non-enhancing multiple cystic areas of the hepatic mass from the early phase (c) to the late phase (d). An axial fat-suppressed MR image with Gd-EOB-DTPA in the hepatobiliary phase (e) shows the hypointense hepatic mass, the extent of which is clearly delineated by increasing the signal intensity of the normal liver parenchyma. 18 F-FDG PET/CT (f) shows no abnormal uptake of FDG in most of the hepatic mass, and increased uptake of FDG in the fraction of the hepatic mass. The cut surface of the resected specimen (g) shows a hepatic mass with multiple hemorrhagic cystic areas.
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Fig1
T2-weighted MR images showed multiple cystic areas with shading in the hepatic mass (Figure 1a). T1-weighted MR images showed some hyperintense cystic areas in the hepatic mass (Figure 1b). MR images with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA), strong enhancement of solid areas in the hepatic mass was prolonged from the early phase to the late phase (Figure 1c, d). MR images with Gd-EOB-DTPA in the hepatobiliary phase showed the hypointense hepatic mass, the extent of which was clearly delineated by increasing the signal intensity of the normal liver parenchyma (Figure 1e). 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT showed no abnormal uptake of FDG in most of the hepatic mass, and an increased uptake of FDG in the fraction of the hepatic mass (Figure 1f). The cut surface of the resected specimen showed a hepatic mass measuring 11 x 8 cm with multiple hemorrhagic cystic areas (Figure 1g).
Primary hepatic carcinoid tumor in 74-year-old female. Unenhanced CT (a) shows a heterogeneous hypodense mass mainly in the right lobe of the liver. Dynamic CT shows prolonged, enhancing, irregular solid areas and non-enhancing areas of the hepatic mass from the early phase (b) to the late phase (c). An axial T1-weighted MR image (d) shows the mainly hypointense mass, including scattered hyperintense cystic areas (arrows). An axial T2-weighted MR image (e) shows the mainly hyperintense mass, including cystic areas with shading (arrows). A celiac arteriogram in the early phase (f) shows an irregular tumor stain, which is supplied by the stretching right and middle hepatic arteries.
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Fig2
Abdominal unenhanced CT showed a heterogeneous hypodense mass 12 cm in diameter, mainly in the right lobe of the liver (Figure 2a). On dynamic CT, irregular solid areas with strong enhancement, which was prolonged from the early phase to the late phase, was observed with non-enhancing areas mixed in the hepatic mass (Figure 2b, c). The hepatic mass was mainly hypointense on T1-weighted MR images (Figure 2d) and hyperintense on T2-weighted MR images (Figure 2e). Abdominal arteriograms showed irregular tumor staining, which was supplied by the stretching right and middle hepatic arteries (Figure 2f).