J Korean Soc Radiol.  2017 Aug;77(2):101-104. 10.3348/jksr.2017.77.2.101.

A Slowly Growing Mass Around a Cirrhotic Liver: Usefulness of the Hepatobiliary Phase in the Diagnosis of Ectopic Liver

• Kim SJ
• Kim KA
• Im S

• KMID: 2386746
• DOI: http://doi.org/10.3348/jksr.2017.77.2.101

Abstract

An ectopic liver is a rare congenital abnormality that is difficult to detect before surgery due to its small size. A 53-year-old man had liver cirrhosis and received regular surveillance. An ovoid mass on the surface of the gallbladder separated from the liver proper was found on computed tomography (CT). The mass had grown slowly over five years of surveillance. Upon further evaluation, the mass exhibited iso-signal intensity compared to liver on T2-weighted images, precontrast T1-weighted images, and the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance imaging (MRI). Surgical resection was performed, and the mass was diagnosed as an ectopic liver with normal liver parenchyma without cirrhotic changes. This case demonstrates that ectopic liver with normal liver tissue can develop in a patient with liver cirrhosis and can grow in the absence of a tumor. MRI with gadoxetic acid is useful to identify this condition correctly.

MeSH Terms

Congenital Abnormalities
Diagnosis*
Gallbladder
Humans
Liver Cirrhosis
Liver*
Magnetic Resonance Imaging
Middle Aged

Figure

• 

  Fig. 1 A slowly growing mass around a cirrhotic liver revealing an ectopic liver in a 53-year-old man. A. Initial dynamic CT scan performed in August 2009 shows a mass (white arrow) adherent to the gallbladder that has the same density as the liver on the portal phase [axial image (left) and the coronal image (right)]. B. Dynamic T1-weighted MR images on arterial phase and showing a mass (white arrow) abutting the gallbladder with mild peripheral enhancement and relatively lower signal intensity in the central portion of the mass. C. Hepatobiliary phase image showing a mass (white arrow) adhering to the gallbladder serosa that is isointense with respect to the liver. D. Fat-suppressed T2-weighted MR image showing a mass (white arrow) with iso-signal intensity relative to the liver parenchyma. E. On whole-body PET-CT performed at that time, the mass (white arrow) showing minimal fluorodeoxyglucose uptake, which is similar to that in the liver. F. Gross specimen showing a lobulated mass (white arrows) abutting the serosal surface of the gall bladder (black arrows). PET = positron emission tomography

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