Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation
Abstract Background Adrenal rest tumor is an ectopic collection of adrenocortical cells in an extra-adrenal site, more frequently located around the kidney, retroperitoneum, spermatic cord, para-testicular region and broad ligament, but very rarely occurring also in the liver. Hepatic adrenal rest t...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-11-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
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| Online Access: | https://doi.org/10.1186/s43055-021-00657-0 |
| _version_ | 1818424951876616192 |
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| author | Piero Boraschi Francesca Turini Francescamaria Donati Francesca Peruzzi Annamaria Bartolucci Niccolò Roffi Piero Colombatto Lucio Urbani |
| author_facet | Piero Boraschi Francesca Turini Francescamaria Donati Francesca Peruzzi Annamaria Bartolucci Niccolò Roffi Piero Colombatto Lucio Urbani |
| author_sort | Piero Boraschi |
| collection | DOAJ |
| description | Abstract Background Adrenal rest tumor is an ectopic collection of adrenocortical cells in an extra-adrenal site, more frequently located around the kidney, retroperitoneum, spermatic cord, para-testicular region and broad ligament, but very rarely occurring also in the liver. Hepatic adrenal rest tumor poses a diagnostic challenge in differentiating it from hepatocellular carcinoma, particularly in a cirrhotic liver. Case presentation An 83-years-old male was referred to our hospital by his family doctor for hepatological evaluation due to multifactorial liver cirrhosis. Ultrasound revealed a centimetric hypoechoic nodule in the VI hepatic segment in the context of a liver with signs of cirrhosis and steatosis. The patient first underwent MRI and then CT, which showed a fat containing focal liver lesion in the subcapsular location of the right lobe, strictly adjacent to the homolateral adrenal gland. The nodule was hypervascular in the arterial phase, washed out in the portal-venous and transitional phases, resulting hypointense in the hepato-biliary phase at MR imaging. In the suspicion of a hepatocellular carcinoma, the nodule was surgically removed, and the patient’s postoperative course was unremarkable. The final histopathological diagnosis was of adrenal rest tumor of the liver. Conclusions Hepatic adrenal rest tumor is an extremely rare hepatic tumor, often without any clinical manifestation, that can also occur in the cirrhotic liver as in our case. Although there are not specific imaging findings, the possible diagnosis of HART should be considered when we observe a well-defined lesion in the subcapsular location of the right lobe, with fat containing, hypervascularity after contrast medium injection and vascular supply from the right hepatic artery. |
| first_indexed | 2024-12-14T14:06:12Z |
| format | Article |
| id | doaj.art-3c448d1e43fb470fb08cbb37762411d7 |
| institution | Directory Open Access Journal |
| issn | 2090-4762 |
| language | English |
| last_indexed | 2024-12-14T14:06:12Z |
| publishDate | 2021-11-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-3c448d1e43fb470fb08cbb37762411d72022-12-21T22:58:32ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622021-11-015211610.1186/s43055-021-00657-0Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlationPiero Boraschi0Francesca Turini1Francescamaria Donati2Francesca Peruzzi3Annamaria Bartolucci4Niccolò Roffi5Piero Colombatto6Lucio Urbani7Department of Diagnostic Imaging, Pisa University HospitalDepartment of Diagnostic Imaging, Pisa University HospitalDepartment of Diagnostic Imaging, Pisa University HospitalDepartment of Diagnostic Imaging, Pisa University HospitalDepartment of Surgical, Medical, Molecular Pathology and Critical Area, University of PisaDepartment of General Surgery, Pisa University HospitalUnit of Hepatology, Pisa University HospitalDepartment of General Surgery, Pisa University HospitalAbstract Background Adrenal rest tumor is an ectopic collection of adrenocortical cells in an extra-adrenal site, more frequently located around the kidney, retroperitoneum, spermatic cord, para-testicular region and broad ligament, but very rarely occurring also in the liver. Hepatic adrenal rest tumor poses a diagnostic challenge in differentiating it from hepatocellular carcinoma, particularly in a cirrhotic liver. Case presentation An 83-years-old male was referred to our hospital by his family doctor for hepatological evaluation due to multifactorial liver cirrhosis. Ultrasound revealed a centimetric hypoechoic nodule in the VI hepatic segment in the context of a liver with signs of cirrhosis and steatosis. The patient first underwent MRI and then CT, which showed a fat containing focal liver lesion in the subcapsular location of the right lobe, strictly adjacent to the homolateral adrenal gland. The nodule was hypervascular in the arterial phase, washed out in the portal-venous and transitional phases, resulting hypointense in the hepato-biliary phase at MR imaging. In the suspicion of a hepatocellular carcinoma, the nodule was surgically removed, and the patient’s postoperative course was unremarkable. The final histopathological diagnosis was of adrenal rest tumor of the liver. Conclusions Hepatic adrenal rest tumor is an extremely rare hepatic tumor, often without any clinical manifestation, that can also occur in the cirrhotic liver as in our case. Although there are not specific imaging findings, the possible diagnosis of HART should be considered when we observe a well-defined lesion in the subcapsular location of the right lobe, with fat containing, hypervascularity after contrast medium injection and vascular supply from the right hepatic artery.https://doi.org/10.1186/s43055-021-00657-0Hepatic adrenal rest tumorLiverLiver neoplasmsCTMR imaging |
| spellingShingle | Piero Boraschi Francesca Turini Francescamaria Donati Francesca Peruzzi Annamaria Bartolucci Niccolò Roffi Piero Colombatto Lucio Urbani Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation The Egyptian Journal of Radiology and Nuclear Medicine Hepatic adrenal rest tumor Liver Liver neoplasms CT MR imaging |
| title | Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation |
| title_full | Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation |
| title_fullStr | Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation |
| title_full_unstemmed | Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation |
| title_short | Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation |
| title_sort | hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis a case report with ct and mri findings and pathologic correlation |
| topic | Hepatic adrenal rest tumor Liver Liver neoplasms CT MR imaging |
| url | https://doi.org/10.1186/s43055-021-00657-0 |
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