Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2022; 10(30): 11066-11073
Published online Oct 26, 2022. doi: 10.12998/wjcc.v10.i30.11066
Hepatic steatosis with mass effect: A case report
Na Hu, Shi-Jun Su, Jin-Ye Li, Hui Zhao, Shan-Feng Liu, Lin-Sheng Wang, Ruo-Zhen Gong, Chuan-Ting Li
Na Hu, Jin-Ye Li, Hui Zhao, Shan-Feng Liu, Lin-Sheng Wang, Department of Radiology, Shandong Provincial ENT Hospital, Shandong University, Jinan 250023, Shandong Province, China
Shi-Jun Su, Department of Radiology, The Fifth People's Hospital of Jinan, Jinan 250022, Shandong Province, China
Ruo-Zhen Gong, Innovation Studio, Shandong Provincial ENT Hospital, Shandong University, Jinan 250023, Shandong Province, China
Chuan-Ting Li, Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan 250021, Shandong Province, China
Author contributions: Hu N, Su SJ, Li JY, and Zhao H reviewed the literature and contributed to manuscript drafting; Liu SF and Wang LS performed the computed tomography and magnetic resonance imaging, and contributed to manuscript drafting; Gong RZ and Li CT were responsible for the revision of the manuscript regarding important intellectual content; All authors issued final approval for the version to be submitted.
Supported by the Medical and Health Science and Technology Development Plan of Shandong, China, No. 2018WS322, No. 202109010865, and No. 202009010992.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chuan-Ting Li, MD, PhD, Doctor, Professor, Department of Radiology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwuweiqi Road, Jinan 250021, Shandong Province, China. lichuanting1@126.com
Received: May 27, 2022
Peer-review started: May 27, 2022
First decision: July 29, 2022
Revised: August 26, 2022
Accepted: September 14, 2022
Article in press: September 14, 2022
Published online: October 26, 2022
Abstract
BACKGROUND

Hepatic steatosis is a common radiologic finding. Some imaging inklings are the absence of a mass effect, and there is currently no report of hepatic steatosis with mass effect.

CASE SUMMARY

A 23-year-old female was admitted due to a liver mass for half a month. No obvious abnormalities were found in physical and laboratory examinations. Ultrasound, computed tomography, and magnetic resonance imaging showed a huge mass between the liver and stomach with a significant mass effect, and the caudate lobe and left lobe of the liver were involved. The signal on T2- and T1- weighted fat-saturated images of the mass was significantly reduced, and the enhanced scan showed inhomogeneous enhancement. Surgical and pathological findings indicated the diagnosis of hepatic steatosis. The operation and re-review of the patient's images showed that the lesion was supplied by the branch of the hepatic artery. The signal on T1-weighted out-of-phase images of the lesion was lower than on in-phase images, and there was no black rim cancellation artifact around the hepatic steatosis area on T1-weighted out-of-phase images. The dynamic enhancement pattern of the lesion was similar to that of the adjacent normal liver parenchyma. The above characteristics suggested that the lesion was hepatic steatosis. However, in this case, the lesion showed exogenous growth and was mass-like, with an obvious mass effect, which has not been reported previously.

CONCLUSION

Hepatic steatosis could grow exogenously and has an obvious mass effect. It needs to be distinguished from fat-rich tumors. The T1-weighted in- and out-of-phase images and dynamic enhanced scanning are valuable for differential diagnosis of this lesion.

Keywords: Hepatic steatosis, Computed tomography, Magnetic resonance imaging, In-phase and out-of-phase imaging, Case report

Core Tip: Hepatic steatosis is a common radiologic finding, which can be divided into diffuse, geographic, focal, multifocal, perivascular, and subcapsular patterns. Some imaging inklings are the absence of a mass effect. Here, we present a case of hepatic steatosis with obvious mass effect and exogenous growth. It needs to be distinguished from liver tumors and other abdominal tumors containing fat. The T1-weighted in- and out-of-phase images and dynamic enhanced scanning have great differential diagnostic values.