Akiyama T, Inamori M, Saito S, Takahashi H, Yoneda M, Fujita K, Fujisawa T, Abe Y, Kirikoshi H, Kubota K, Ueda M, Tanaka K, Togo S, Ueno N, Shimada H, Nakajima A. Levovist ultrasonography imaging in intracystic hemorrhage of simple liver cyst. World J Gastroenterol 2008; 14(5): 805-807 [PMID: 18205277 DOI: 10.3748/wjg.14.805]
Corresponding Author of This Article
Masahiko Inamori, MD, PhD, Division of Gastroenterology, Yokohama city University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. inamorim@med.yokohama-cu.ac.jp
Article-Type of This Article
Case Report
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Tomoyuki Akiyama, Masahiko Inamori, Satoru Saito, Hirokazu Takahashi, Masato Yoneda, Koji Fujita, Toshio Fujisawa, Yasunobu Abe, Hiroyuki Kirikoshi, Kensuke Kubota, Norio Ueno, Atsushi Nakajima, Division of Gastroenterology, Yokohama city University Hospital, Yokohama 236-0004, Japan
Michio Ueda, Kuniya Tanaka, Shinji Togo, Hiroshi Shimada, Division of Surgery, Yokohama city University Hospital, Yokohama 236-0004, Japan
Correspondence to: Masahiko Inamori, MD, PhD, Division of Gastroenterology, Yokohama city University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. inamorim@med.yokohama-cu.ac.jp
Telephone: +81-45-7872640
Fax: +81-45-787-8988
Received: October 1, 2007 Revised: December 6, 2007 Published online: February 7, 2008
Abstract
The differential diagnosis between intracystic hemorrhage and cystadenocarcinoma of the liver is often difficult even with the use of various imaging modalities. A 73-year-old woman was admitted to our hospital with the complaint of right upper quadrant pain. Ultrasonography (US) demonstrated a heterogeneous echogenic cyst measuring 11 cm × 8 cm in size in S2 of the liver, indicated intracystic hemorrhage of simple liver cyst or cystadenocarcinoma, but the differential diagnosis was considerably difficult. Levovist (Schering, Berlin, Germany) US revealed no enhancement of the intracystic structures, suggesting a clot in the case of intracystic hemorrhage. An operation was performed and the resected lesion showed a solitary benign liver cyst, measuring 5.5 cm × 4.7 cm × 8.5 cm containing a large blood clot. The patient had an uneventful recovery after the surgery. Levovist US may play an important role in discrimination between intracystic hemorrhage of simple hepatic cysts and cystadenocarcinoma of the liver.
