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Detection and quantification of a focal fat deposition in a liver undergoing multiple operations for neuroendocrine tumor disease using attenuation imaging: a case report
BACKGROUND: In patients with history of malignancy, new-onset liver lesions often present diagnostic challenges. We present the case of a patient with history of neuroendocrine tumor and new-onset echo-rich hepatic lesion, in whom attenuation imaging helped to make the diagnosis. Attenuation imaging...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9843950/ https://www.ncbi.nlm.nih.gov/pubmed/36647135 http://dx.doi.org/10.1186/s13256-022-03723-x |
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author | Miller, Elisabeth Kratzer, Wolfgang Kestler, Angelika |
author_facet | Miller, Elisabeth Kratzer, Wolfgang Kestler, Angelika |
author_sort | Miller, Elisabeth |
collection | PubMed |
description | BACKGROUND: In patients with history of malignancy, new-onset liver lesions often present diagnostic challenges. We present the case of a patient with history of neuroendocrine tumor and new-onset echo-rich hepatic lesion, in whom attenuation imaging helped to make the diagnosis. Attenuation imaging is an ultrasound-based technique that allows for the quantification of hepatic fat content on the basis of a measurement of sound attenuation. CASE PRESENTATION: We present the case of a 62-year-old Caucasian female patient who underwent pylorus-preserving pancreaticoduodenectomy Whipple surgery in 2004 for histologically well-differentiated neuroendocrine tumor with a proliferation rate of 3% of the pancreatic head. During the course, single liver metastases were resected in 2009, 2010, and 2013. In 2019, hemihepatectomy was performed when two liver metastases recurred. The liver metastases each showed a proliferation rate of 10% with vigorous expression of chromogranin A, synaptophysin, and somatostatin. The most recent follow-up examinations showed a normal chromogranin A value and the patient reported a good general condition. However, sonography revealed a blurred, echoic lesion in the liver. On contrast-enhanced sonography, the lesion showed identical behavior to the surrounding liver parenchyma. In the asymptomatic patient, liver biopsy did not seem to be indicated at the current time. Measurement of the attenuation coefficient by attenuation imaging showed a significantly higher measurement in the area of the echo-rich lesion than in the rest of the liver. The overall findings are consistent with focal fat deposition. CONCLUSIONS: Attenuation imaging appears to be useful in the evaluation of unclear echo-rich liver lesions. In particular, primary non-malignant-appearing liver lesions that are unremarkable on abdominal contrast-enhanced ultrasound can be more accurately assessed. |
format | Online Article Text |
id | pubmed-9843950 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-98439502023-01-18 Detection and quantification of a focal fat deposition in a liver undergoing multiple operations for neuroendocrine tumor disease using attenuation imaging: a case report Miller, Elisabeth Kratzer, Wolfgang Kestler, Angelika J Med Case Rep Case Report BACKGROUND: In patients with history of malignancy, new-onset liver lesions often present diagnostic challenges. We present the case of a patient with history of neuroendocrine tumor and new-onset echo-rich hepatic lesion, in whom attenuation imaging helped to make the diagnosis. Attenuation imaging is an ultrasound-based technique that allows for the quantification of hepatic fat content on the basis of a measurement of sound attenuation. CASE PRESENTATION: We present the case of a 62-year-old Caucasian female patient who underwent pylorus-preserving pancreaticoduodenectomy Whipple surgery in 2004 for histologically well-differentiated neuroendocrine tumor with a proliferation rate of 3% of the pancreatic head. During the course, single liver metastases were resected in 2009, 2010, and 2013. In 2019, hemihepatectomy was performed when two liver metastases recurred. The liver metastases each showed a proliferation rate of 10% with vigorous expression of chromogranin A, synaptophysin, and somatostatin. The most recent follow-up examinations showed a normal chromogranin A value and the patient reported a good general condition. However, sonography revealed a blurred, echoic lesion in the liver. On contrast-enhanced sonography, the lesion showed identical behavior to the surrounding liver parenchyma. In the asymptomatic patient, liver biopsy did not seem to be indicated at the current time. Measurement of the attenuation coefficient by attenuation imaging showed a significantly higher measurement in the area of the echo-rich lesion than in the rest of the liver. The overall findings are consistent with focal fat deposition. CONCLUSIONS: Attenuation imaging appears to be useful in the evaluation of unclear echo-rich liver lesions. In particular, primary non-malignant-appearing liver lesions that are unremarkable on abdominal contrast-enhanced ultrasound can be more accurately assessed. BioMed Central 2023-01-17 /pmc/articles/PMC9843950/ /pubmed/36647135 http://dx.doi.org/10.1186/s13256-022-03723-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Miller, Elisabeth Kratzer, Wolfgang Kestler, Angelika Detection and quantification of a focal fat deposition in a liver undergoing multiple operations for neuroendocrine tumor disease using attenuation imaging: a case report |
title | Detection and quantification of a focal fat deposition in a liver undergoing multiple operations for neuroendocrine tumor disease using attenuation imaging: a case report |
title_full | Detection and quantification of a focal fat deposition in a liver undergoing multiple operations for neuroendocrine tumor disease using attenuation imaging: a case report |
title_fullStr | Detection and quantification of a focal fat deposition in a liver undergoing multiple operations for neuroendocrine tumor disease using attenuation imaging: a case report |
title_full_unstemmed | Detection and quantification of a focal fat deposition in a liver undergoing multiple operations for neuroendocrine tumor disease using attenuation imaging: a case report |
title_short | Detection and quantification of a focal fat deposition in a liver undergoing multiple operations for neuroendocrine tumor disease using attenuation imaging: a case report |
title_sort | detection and quantification of a focal fat deposition in a liver undergoing multiple operations for neuroendocrine tumor disease using attenuation imaging: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9843950/ https://www.ncbi.nlm.nih.gov/pubmed/36647135 http://dx.doi.org/10.1186/s13256-022-03723-x |
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