Case of the Month August 2015, Page 2

Answer: According to the ACR Appropriateness Criteria, an abdominal ultrasound is the most appropriate initial study.

Ultrasound showed no gallstones or biliarydilatation, but did demonstrate the following:

For larger images, please click on Ultrasound 1 and Ultrsaound 2

A 4.6 x 2.9 x 2.5 cm mixed solid and cystic structure is present at the inferior tip of the liver (circled in yellow).  The solid component exhibits vascularity (yellow arrow).

Which of the following would be at the top of the differential diagnosis for this lesion?

A. Hepatic metastasis
B. Hepatocellularcarcinoma
C. Simple hepatic cyst
D. Hemangioma

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