A 58-year-old man with chronic hepatitis B and HIV co-infection underwent abdominal
ultrasound for liver cancer screening. A 25 mm focal hypoechoic lesion was discovered in segment VII. Liver function tests and
tumour markers levels (α-fetoprotein, CEA, ca 19.9) were normal. On contrast abdominal
computed tomography the mass was enhanced heterogeneously in the arterial phase with
minimal washout in the portal and delayed phases. On superparamagnetic iron oxide-enhanced
magnetic resonance imaging the lesion appeared to be slightly hypointense on T1 (Fig. 1A), hyperintense on T2 fat suppression and clearly hypervascular in the arterial phase
(Fig. 1B). Based on the radiological findings and the clinical history a diagnosis of hepatocellular
carcinoma (HCC) was suspected. The patient underwent subsegmental liver resection
and the postoperative recovery was uneventful. At histology the lesion was diagnosed
as an adrenal rest tumour based on morphology and immunostaining (staining was positive
for cytokeratin, vimentin, α-inhibin; negative for polyclonal CEA and hepatocyte specific
antigen 1). The lesion was adjacent to an area of mature adrenal cortex, surrounded
by hepatic tissue (Fig. 1C).
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Reference
- Nonfunctioning adrenal rest tumor of the liver: radiologic appearance.J Comput Assist Tomogr. 2001; 25: 98-101
Article info
Publication history
Published online: April 04, 2014
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© 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Inc. All rights reserved.
