Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 26, 2021; 9(21): 5948-5954
Published online Jul 26, 2021. doi: 10.12998/wjcc.v9.i21.5948
Contrast enhanced ultrasound in diagnosing liver lesion that spontaneously disappeared: A case report
Zong-Ding Wang, Salameen Haitham, Jian-Ping Gong, Zi-Li Pen
Zong-Ding Wang, Zi-Li Pen, Department of Surgery, Fengjie People’s Hospital, Chongqing 400010, China
Salameen Haitham, Jian-Ping Gong, Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
Author contributions: Wang ZD collected the patient's information and wrote the paper; Haitham S wrote and edited the paper; Gong JP and Pen ZL reviewed and revised the paper.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: The authors declare they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zi-Li Pen, MD, PhD, Chief Doctor, Surgeon, Department of Surgery, Fengjie People’s Hospital, No. 2 Kangning Street, Chongqing 400010, China. 623645246@qq.com
Received: November 19, 2020
Peer-review started: November 19, 2020
First decision: December 28, 2020
Revised: January 17, 2021
Accepted: April 6, 2021
Article in press: April 6, 2021
Published online: July 26, 2021
Processing time: 238 Days and 3.1 Hours
Abstract
BACKGROUND

Focal liver lesions (FLLs) are abnormal masses that are distinguishable from the surrounding liver parenchyma, solid or cystic and may be benign or malignant. They are usually detected incidentally on abdominal examinations. The classification of FLLs is very important as it directly determines the diagnosis and treatment of patients.

CASE SUMMARY

A 46-year-old male patient was admitted into the hospital with tarry stool, during the investigation of this issue an incidental FLL was detected. Upon further investigation of this “incidentaloma” computerized tomography and magnetic resonance imaging reached contradictory conclusions. The lesion was then further investigated using contrast-enhanced ultrasound (CEUS) with an initial diagnosis of idiopathic FLL was acquired and observation of the FLL over time need for final diagnosis, however in the follow up the FLL disappeared spontaneously.

CONCLUSION

CEUSs value for characterization of FLLs is undeniable, especially when other methods produce inconsistent results, is undeniable but with its limitations. Why and how the FLL disappeared is not known, and can be only hypothesized it was a pseudolesion.

Keywords: Liver; Ultrasonography; Tomography; Contrast enhanced ultrasound; Focal liver lesions; Case report

Core Tip: This case report describes a patient with an incidentally detected focal liver lesion (FLL) in a routine computerized tomography (CT) scan preformed for an unrelated issue. After further investigation of the FLL, the CT scans gave a conclusion of hepatic hemangioma and couldn’t exclude neoplastic, while the magnetic resonance imaging scans diagnosed the lesion as small hepatocellular carcinoma, thus contrast-enhanced ultrasound (CEUS) was preformed to accurately diagnose the lesion which initially gave us a possible diagnosis of a benign idiopathic lesion, and observation over time required for a final diagnosis. In the 1, 3, 6 and 12 mo post-discharge follow up, the lesion spontaneously disappeared, and no final diagnosis was acquired as to what FLL might be. CEUS is very useful at diagnosing FLL but still has its limitations.