Transarterial embolization with bleomycin-lipiodol emulsion: a successful minimal invasive approach for giant liver hemangioma

Hemangiomas are most common benign liver tumor. Most patients have an excellent prognosis because of the small size and benign nature of tumor. On some occasions, giant liver hemangioma may cause symptoms and significant challenges due to its complication. We report a case of giant liver hemangioma treated with minimal invasive approach by transarterial embolization (TAE). Following three TAE sessions over a specific timeframe, the patient was successfully managed, addressing that TAE may be a useful alternative to hepatic surgery in such cases.

Hepatocellular Carcinoma with Macroscopic Fat Metamorphosis: A Case Series

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths in the world, with hepatitis B and C as its main causes. HCC can have fat metamorphosis which leads to a better prognosis, though this is more commonly found in lesions smaller than 3 cm in diameter, and usually contains intravoxel fat. In this case series, we present three cases of HCC with macroscopic fat metamorphosis as examined using CT scan and MRI. Macroscopic fat is seen using CT as a hypodense mass with attenuation of −10 to −100 HU, or MRI using fat-saturation technique. Intravoxel fat can be seen on MRI using fat saturation chemical shift technique, appearing as signal loss during opposed phase and increased signal during in-phase. The differential diagnoses of HCC with fat metamorphosis are angiomyolipoma, hepatic adenoma, nodular steatosis, focal nodular hyperplasia, dysplastic nodule, liposarcoma, and hepatic metastasis. Enhancement patterns of the fat and non-fat component; intra-tumoral fat distribution; the presence of cirrhosis; the presence of atoll sign; and history of viral hepatitis are useful clues for differentiation of HCC with other differential diagnoses.