A benign tumour of the liver mimicking malignant liver disease--cholangiocellular adenoma.
OBJECTIVE
To describe three patients with liver lesions mimicking malignant tumours diagnosed finally, using contrast-enhanced ultrasound, as cholangiocellular adenoma (bile duct adenoma).


METHODS
Focal liver lesions found incidentally in three patients. Contrast-enhanced ultrasound was with use of Siemens or Esaote equipment, low MI technique, after an intravenous bolus of 2.4 ml Sonovue (Bracco, Italy).


RESULTS
Lesions were 9 mm, 15 mm and 20 mm in diameter and all were enhanced in the arterial phase and hypo-enhanced in the portal venous and late phases, suggesting their malignant nature. In two patients, no primary liver tumour was found, and in the third patient, previously resected for breast cancer, a tissue specimen was considered useful for characterizing tumour receptors for more targeted chemotherapy, the lesion being assumed metastatic in nature. Transcutaneous core biopsies were performed in all three patients. Pathological analysis (including the reference pathology) revealed cholangiocellular adenoma in all of them.


CONCLUSIONS
Cholangiocellular adenoma is a rare entity and can be a reason for possible false malignant diagnosis using contrast-enhanced ultrasound. Follow-up examinations are recommended.
Ignee
Andre
A
Department of Internal Medicine 2, Caritas Hospital Bad Mergentheim, Germany.
Piscaglia
Fabio
F
Ott
Michaela
M
Salvatore
Veronica
V
Dietrich
Christoph F
CF
D002759:Adenoma, Bile Duct / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D010743:Phospholipids; D018570:Risk Assessment; D012494:Sampling Studies; D013459:Sulfur Hexafluoride; D018615:Ultrasonography, Doppler, Color
D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride