title: Case 235: Hepatic Adenomatosis Due to Inflammatory Adenomas.
abstract: History An asymptomatic 33-year-old woman was referred to the Hepatology Department in 2013 for work-up of indeterminate multifocal liver masses. These lesions were discovered incidentally at multiphase contrast material-enhanced multidetector computed tomography (CT) performed in 2004 to investigate right lower quadrant pain. Imaging surveillance at sporadic intervals revealed slow progressive growth of the lesions over time; however, the number of lesions remained constant. There was no history of cancer, nor were there predisposing factors for chronic liver disease or cirrhosis. The patient had a history of menorrhagia, which was managed with oral contraceptive use for 20 years; this was stopped in 2013 after hysterectomy. The patient's γ-glutamyl transferase (77 U/L [1.28 μkat/L]; normal level, <55 U/L [<0.92 μkat/L]) and C-reactive protein (97.1 mg/L [924.8 nmol/L]; normal level, <8 mg/L [<76.2 nmol/L]]) levels were chronically elevated at serum testing. In 2013, 9 years after the initial CT examination, magnetic resonance (MR) imaging with gadoxetic acid (Primovist; Bayer Healthcare, Whippany, NJ) was performed. Finally, ultrasonography (US)-guided biopsy of one of the lesions (in segment 5/6) was performed a year after MR imaging.
authors.affiliation: From the Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, 8440-112 St, 2A2.41 WMC, Edmonton, AB, Canada T6G 2B7.
authors.forename: Gavin
authors.initials: G
authors.lastname: Low
authors.affiliation: From the Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, 8440-112 St, 2A2.41 WMC, Edmonton, AB, Canada T6G 2B7.
authors.forename: Harini
authors.initials: H
authors.lastname: Dharmana
authors.affiliation: From the Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, 8440-112 St, 2A2.41 WMC, Edmonton, AB, Canada T6G 2B7.
authors.forename: Samantha
authors.initials: S
authors.lastname: Saravana-Bawan
authors.affiliation: From the Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, 8440-112 St, 2A2.41 WMC, Edmonton, AB, Canada T6G 2B7.
authors.forename: Safwat
authors.initials: S
authors.lastname: Girgis
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging*; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood; D003287:Contrast Media; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D061705:Image-Guided Biopsy; D033162:Incidental Findings; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging*; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional
chemical_list: D014408:Biomarkers, Tumor; D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA