Published online Oct 26, 2022. doi: 10.12998/wjcc.v10.i30.11066
Peer-review started: May 27, 2022
First decision: July 29, 2022
Revised: August 26, 2022
Accepted: September 14, 2022
Article in press: September 14, 2022
Published online: October 26, 2022
Processing time: 146 Days and 22.5 Hours
Hepatic steatosis is a common radiologic finding. Some imaging inklings are the absence of a mass effect, and there is currently no report of hepatic steatosis with mass effect.
A 23-year-old female was admitted due to a liver mass for half a month. No obvious abnormalities were found in physical and laboratory examinations. Ultrasound, computed tomography, and magnetic resonance imaging showed a huge mass between the liver and stomach with a significant mass effect, and the caudate lobe and left lobe of the liver were involved. The signal on T2- and T1- weighted fat-saturated images of the mass was significantly reduced, and the enhanced scan showed inhomogeneous enhancement. Surgical and pathological findings indicated the diagnosis of hepatic steatosis. The operation and re-review of the patient's images showed that the lesion was supplied by the branch of the hepatic artery. The signal on T1-weighted out-of-phase images of the lesion was lower than on in-phase images, and there was no black rim cancellation artifact around the hepatic steatosis area on T1-weighted out-of-phase images. The dynamic enhancement pattern of the lesion was similar to that of the adjacent normal liver parenchyma. The above characteristics suggested that the lesion was hepatic steatosis. However, in this case, the lesion showed exogenous growth and was mass-like, with an obvious mass effect, which has not been reported previously.
Hepatic steatosis could grow exogenously and has an obvious mass effect. It needs to be distinguished from fat-rich tumors. The T1-weighted in- and out-of-phase images and dynamic enhanced scanning are valuable for differential diagnosis of this lesion.
Core Tip: Hepatic steatosis is a common radiologic finding, which can be divided into diffuse, geographic, focal, multifocal, perivascular, and subcapsular patterns. Some imaging inklings are the absence of a mass effect. Here, we present a case of hepatic steatosis with obvious mass effect and exogenous growth. It needs to be distinguished from liver tumors and other abdominal tumors containing fat. The T1-weighted in- and out-of-phase images and dynamic enhanced scanning have great differential diagnostic values.