PMC4290065_01
A 55-year-old gentleman with solitary hypervascular mass in the right lobe of liver on dynamic computed tomography (CT). (a) Mildly hypodense mass (*) in the region of right lobe of liver on noncontrast CT scan. (b) The mass (*) shows arterial hypervascularity along its periphery (bold arrow). (c) The lesion showed contrast washout on the portal venous phase and was seen to encase the anterior division of the right portal vein. (d) Washout persistent in the equilibrium phase in the mass (*)
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F1
An arterial phase enhancing, well defined lobulated, rounded, hypervascular lesion measuring approximately 10 cm in its largest diameter was present in the right lobe of the liver (segments VIII and V) [Figure 1a-d].
A 55-year-old man with hypervascular hepatic neuroendocrine tumor secondary deposit. (a) The fat-suppressed T1-weighted fast spin-echo, magnetic resonance imaging (MRI) image performed after the dynamic computed tomography (CT) shows a hypointense mass (*) in right lobe (block arrow) (b) The fat-suppressed T2-weighted fast spin-echo, MRI image performed after the dynamic CT shows a hyperintense mass (*) in the right lobe of liver (block arrow) and in caudate lobe (open white arrow). (c) The axial diffusion weighted image of b value 1000 shows restriction of the lesion (*) on T2-weighted (block and open arrows). b value = 1000. (d) The fat-suppressed T1-weighted fast spin-echo, dynamic MRI in the arterial phase shows a hypervascular enhancing mass (*) in the right lobe of liver (block arrow) (e) Fat-suppressed T1-weighted fast spin-echo, dynamic MRI in the portal venous phase shows an encapsulated mass (*) with central washout in the right lobe of liver (block arrow). (f) The fat-suppressed T1-weighted fast spin-echo, dynamic magnetic resonance imaging MRI in the equilibrium phase shows an encapsulated mass (*) with better visualized central hypointensity in the right lobe of liver (block arrow). (g) The fat-suppressed T1-weighted fast spin-echo, dynamic MRI in the hepatocyte specific phase at 90 min shows an encapsulated mass (*) with central hypointensity in the right lobe of liver (block arrow)
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F2
With subsequent washout on portal venous and delayed hepatobiliary phase obtained at 90 min post injection [Figure 2a-g].
Explanted right hepatectomy specimen with tumor. (a) Explanted right hepatectomy specimen with tumor (*). (b) Cut surface of the tumor (*) specimen after resection. (c) Gross pathology specimen with tumor (*)
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F3
Right hepatectomy specimen was sent for histopathological analysis [Figure 3a and b] on gross pathology examination; transection margin was found to be 1 cm away from the tumor mass and was free from the tumor [Figure 3c].
(a) Axial section of DOTA-NaI-octreotide (DOTANOC) positron emission tomography/computed tomography (PET/CT) showing reactive focus in the small bowel mesentery (*). (b, c) Coronal section of DOTANOC PET/CT (bold arrow) and isotope scan (outlined arrow) showing reactive focus in the small bowel mesentery
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F4
The scan was suggestive of nodular activity in the distal small bowel mesentery, in the right lower abdomen with an associated reactive focus in the ileum [Figure 4a-c].