title: Hepatic adenoma mimicking a metastatic lesion on computed tomography-positron emission tomography scan.
abstract: Positron emission tomography (PET) using ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) is an imaging modality which reflects cellular glucose metabolism. Most malignant cells accumulate and trap ¹⁸F-FDG, allowing the visualisation of increased uptake. It is hence widely used to differentiate malignant from benign lesions. "False positive" findings of hepatic lesions have been described in certain instances such as hepatic abscesses, but are rare in cases involving hepatocellular adenomas. To our knowledge, there have been only 7 reports in the English literature documenting PET-avid hepatocellular adenomas; 6 of the 7 reports were published in the last 3 years with the first report by Patel et al. We report the case of a 44-year-old Chinese female patient with a history of cervical adenocarcinoma, referred for a hepatic lesion noted on a surveillance computed tomography (CT) scan. A subsequent CT-PET performed showed a hypermetabolic lesion (standardized uptake value 7.9) in segment IVb of the liver. After discussion at a multi-disciplinary hepato-pancreato-biliary conference, the consensus was that of a metastatic lesion from her previous cervical adenocarcinoma, and a resection of the hepatic lesion was performed. Histology revealed features consistent with a hepatocyte nuclear factor-1 α inactivated steatotic hepatocellular adenoma.
authors.affiliation: Department of General Surgery, Singapore General Hospital, Singapore 169608, Singapore.
authors.forename: Darryl
authors.initials: D
authors.lastname: Lim
authors.forename: Ser Yee
authors.initials: SY
authors.lastname: Lee
authors.forename: Kiat Hon
authors.initials: KH
authors.lastname: Lim
authors.forename: Chung Yip
authors.initials: CY
authors.lastname: Chan
mesh_terms: D000236:Adenoma / Q000150:complications / Q000000981:diagnostic imaging*; D000328:Adult; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000378:metabolism; D007044:Hysterectomy; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000150:complications
chemical_list: C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-fluorodeoxyglucose; Hepatic adenoma; Hepatocellular adenoma; Hepatocyte nuclear factor-1 α; Positron emission tomography