Hemorrhagic Hepatic Cyst mimicking a Biliary Neoplasm in a patient with Polycystic Liver Disease: Report of a Case with emphasis on Contrast-Enhanced Ultrasound with SonoVue®.

Volume 1, Issue 2, December 2016     |     PP. 196-206      |     PDF (511 K)    |     Pub. Date: December 23, 2016
DOI:    364 Downloads     7411 Views  

Author(s)

Antonio Corvino, University of Naples "Parthenope", Via Medina 40, 80133, Naples, Italy; Department of Radiology, National Cancer Institute, Pascale Foundation, via M. Semmola, Naples, I-80131, Italy.
Orlando Catalano, Department of Radiology, National Cancer Institute, Pascale Foundation, via M. Semmola, Naples, I-80131, Italy.
Fabio Corvino, Department of Advanced Medical Biosciences, University Federico II of Napoli (UNINA), Biostructures and Bioimmages Institution (IBB), National Research Council (CNR), via S. Pansini, Naples, I-80131, Italy.

Abstract
The occurrence of intracystic hemorrhage in benign liver cysts is usually seen in huge solitary cysts and in older individuals. We report a case of multiple simple hepatic cysts with intracystic hemorrhage complicating one of the cysts in whom the correct diagnosis was accurately made by Contrast-Enhanced Low-MI Real-Time Ultrasound (CEUS) Imaging with Sonovue® (Bracco, Milano, Italy). Our report emphasize on the crucial role of CEUS as imaging modality in providing the informations needed to differentiate haemorragic cysts from cystic liver tumors such as cystadenoma and cystadenocarcinoma, potentially avoiding the use of more invasive and expensive imaging modalities such as CT or MRI imaging.

Keywords
Contrast-enhanced Ultrasound (CEUS); Haemorragic cysts; Polycystic liver disease; Complex Cystic Liver Lesions; Microbubbles;

Cite this paper
Antonio Corvino, Orlando Catalano, Fabio Corvino, Hemorrhagic Hepatic Cyst mimicking a Biliary Neoplasm in a patient with Polycystic Liver Disease: Report of a Case with emphasis on Contrast-Enhanced Ultrasound with SonoVue®. , SCIREA Journal of Clinical Medicine. Volume 1, Issue 2, December 2016 | PP. 196-206.

References

[ 1 ] Kawano Y, Yoshida H, Mamada Y, Taniai N, Mineta S, Yoshioka M, Mizuguchi Y, Katsuta Y, Kawamoto C, Uchida E (2011) Intracystic hemorrhage required no treatment from one of multiple hepatic cysts. J Nippon Med Sch 78(5):312-6.
[ 2 ] Hara H, Morita S, Sako S, Dohi T, Iwamoto M, Inoue H, Tanigawa N (2001) Hepatobiliary cystadenoma combined with multiple liver cysts: report of a case. Surg Today 31(7):651-4.
[ 3 ] Xu HX, Lu MD, Liu LN, Zhang YF, Guo LH, Liu C, Wang S (2012) Imaging features of intrahepatic biliary cystadenoma and cystadenocarcinoma on B-mode and contrast-enhanced ultrasound. Ultraschall Med 33(7):E241-9. doi: 10.1055/s-0031-1299276. Epub 2012 Nov 15.
[ 4 ] Catalano O, Nunziata A, Lobianco R, Siani A (2005) Real-time harmonic contrast material-specific US of focal liver lesions. Radiographics 25:333–349.
[ 5 ] Bartolotta TV, Taibbi A, Midiri M, Lagalla R (2009) Focal liver lesions: contrast-enhanced ultrasound. Abdom Imaging 34(2):193-209. doi: 10.1007/s00261-008-9378-6.
[ 6 ] Corvino A, Catalano O, Setola SV, Sandomenico F, Corvino F, Petrillo A (2015) Contrast-enhanced ultrasound in the characterization of complex cystic focal liver lesions. Ultrasound Med Biol 41(5):1301-10. doi: 10.1016/j.ultrasmedbio.2014.12.667. Epub 2015 Feb 7
[ 7 ] Mortelé KJ, Peters HE (2009) Multimodality imaging of common and uncommon cystic focal liver lesions. Semin Ultrasound CT MR 30(5):368-86.
[ 8 ] Borhani AA, Wiant A, Heller MT (2014) Cystic hepatic lesions: a review and an algorithmic approach. AJR Am J Roentgenol 203(6):1192-204. doi: 10.2214/AJR.13.12386.
[ 9 ] Hagiwara A, Inoue Y, Shutoh T, Kinoshita H, Wakasa K (2001) Haemorrhagic hepatic cyst: a differential diagnosis of cystic tumour. Br J Radiol 74(879):270-2.
[ 10 ] Vachha B, Sun MR, Siewert B, Eisenberg RL (2011) Cystic lesions of the liver. AJR Am J Roentgenol 196(4):W355-66. doi: 10.2214/AJR.10.5292.
[ 11 ] Piscaglia F, Lencioni R, Sagrini E, Pina CD, Cioni D, Vidili G, Bolondi L (2010) Characterization of focal liver lesions with contrast-enhanced ultrasound. Ultrasound Med Biol 36(4):531-50. doi: 10.1016/j.ultrasmedbio.2010.01.004.
[ 12 ] Sutherland T, Temple F, Lee WK, Hennessy O (2011) Evaluation of focal hepatic lesions with ultrasound contrast agents. J Clin Ultrasound 39(7):399-407. doi: 10.1002/jcu.20847. Epub 2011 Jun 14.
[ 13 ] Lin MX, Xu HX, Lu MD, Xie XY, Chen LD, Xu ZF, Liu GJ, Xie XH, Liang JY, Wang Z (2009) Diagnostic performance of contrast-enhanced ultrasound for complex cystic focal liver lesions: blinded reader study. Eur Radiol 19(2):358-69. doi: 10.1007/s00330-008-1166-8. Epub 2008 Sep 16.
[ 14 ] Wilson SR, Jang HJ, Kim TK, Burns PN (2007) Diagnosis of focal liver masses on ultrasonography: comparison of unenhanced and contrast-enhanced scans. J Ultrasound Med 26(6):775-87; quiz 788-90.
[ 15 ] Ascenti G, Mazziotti S, Zimbaro G et al (2007) Complex cystic renal masses: Characterization with contrast-enhanced US Radiology 243:158–165.
[ 16 ] Naganuma H, Funaoka M, Fujimori S, Ishida H, Komatsuda T, Yamada M, Furukawa K (2006) Hepatic cyst with intracystic bleeding: contrast-enhanced sonographic findings. J Med Ultrasonics 33:105–107 DOI 10.1007/s10396-005-0084-5.
[ 17 ] Akiyama T, Inamori M, Saito S, Takahashi H, Yoneda M, Fujita K, Fujisawa T, Abe Y, Kirikoshi H, Kubota K, Ueda M, Tanaka K, Togo S, Ueno N, Shimada H, Nakajima A (2008) Levovist ultrasonography imaging in intracystic hemorrhage of simple liver cyst. World J Gastroenterol 14(5):805-7.
[ 18 ] Corvino A, Catalano O, Corvino F, Petrillo A (2015) Rectal melanoma presenting as a solitary complex cystic liver lesion: role of contrast-specific low-MI real-time ultrasound imaging. J Ultrasound 19(2):135-9. doi: 10.1007/s40477-015-0182-1.