Abstract
Peritumoral fat-spared area (PTFSA), a focal spared area surrounding hepatic tumors, is a specific finding of liver tumors in fatty livers. PTFSA mimics a liver tumor, making it difficult to recognize the tumor boundary. We report a case of a 56-year-old man with fatty liver who was diagnosed with a liver tumor. Ultrasonography (US) revealed a nearly homogeneous hyperechoic liver tumor measuring 40 mm in the left lobe. A thick hypoechoic area was observed around the tumor that spread more widely than an ordinary halo. Histological examination revealed that the hypoechoic area comprised a thin fibrous capsule and normal liver parenchyma without fat, which is PTFSA. Contrast-enhanced US (CEUS) indicated corona enhancement only at the inner part of the PTFSA. The inner part showed the same pattern as that of an ordinary halo and was a part of hepatocellular carcinoma, whereas the outer part showed the same pattern as that of the other liver parenchyma. CEUS was an effective modality for distinguishing the difference. Thus, CEUS was useful in defining the tumor boundary. Before initiating treatment, tumors should be evaluated using various modalities to detect their accurate boundary. CEUS may be a useful modality for detecting the boundary and making a diagnosis.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.
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Ikeda, A., Oiwa, Y. & Kokuryu, H. Contrast-enhanced ultrasonography evaluation of hepatocellular carcinoma with peritumoral fat-spared area: a case report. J Med Ultrasonics 45, 325–329 (2018). https://doi.org/10.1007/s10396-017-0822-5
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DOI: https://doi.org/10.1007/s10396-017-0822-5