Case of the Month August 2015, page 3

Answer: Given the clinical history of rectal cancer, this lesion should raise concern for a metastasis.  Hepatocellularcarcinoma would be less likely in this patient with no history of cirrhosis or other risk factors for a primary hepatic malignancy.  A simple cyst would not exhibit vascularity, as this lesion does.  A hemangiomawould typically be hyperechoic, unlike the hypoechoiclesion seen here.


What imaging study should be ordered next?

A.CT with contrast
B. Repeat ultrasound in three months
C. MRI with contrast
D. Angiography with embolization

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