Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation

Abstract Background Adrenal rest tumor is an ectopic collection of adrenocortical cells in an extra-adrenal site, more frequently located around the kidney, retroperitoneum, spermatic cord, para-testicular region and broad ligament, but very rarely occurring also in the liver. Hepatic adrenal rest t...

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Autores principales:	Piero Boraschi, Francesca Turini, Francescamaria Donati, Francesca Peruzzi, Annamaria Bartolucci, Niccolò Roffi, Piero Colombatto, Lucio Urbani
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Hepatic adrenal rest tumor Liver Liver neoplasms CT MR imaging Medical physics. Medical radiology. Nuclear medicine R895-920
Acceso en línea:	https://doaj.org/article/3c448d1e43fb470fb08cbb37762411d7
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spelling	oai:doaj.org-article:3c448d1e43fb470fb08cbb37762411d72021-11-21T12:26:49ZHepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation10.1186/s43055-021-00657-02090-4762https://doaj.org/article/3c448d1e43fb470fb08cbb37762411d72021-11-01T00:00:00Zhttps://doi.org/10.1186/s43055-021-00657-0https://doaj.org/toc/2090-4762Abstract Background Adrenal rest tumor is an ectopic collection of adrenocortical cells in an extra-adrenal site, more frequently located around the kidney, retroperitoneum, spermatic cord, para-testicular region and broad ligament, but very rarely occurring also in the liver. Hepatic adrenal rest tumor poses a diagnostic challenge in differentiating it from hepatocellular carcinoma, particularly in a cirrhotic liver. Case presentation An 83-years-old male was referred to our hospital by his family doctor for hepatological evaluation due to multifactorial liver cirrhosis. Ultrasound revealed a centimetric hypoechoic nodule in the VI hepatic segment in the context of a liver with signs of cirrhosis and steatosis. The patient first underwent MRI and then CT, which showed a fat containing focal liver lesion in the subcapsular location of the right lobe, strictly adjacent to the homolateral adrenal gland. The nodule was hypervascular in the arterial phase, washed out in the portal-venous and transitional phases, resulting hypointense in the hepato-biliary phase at MR imaging. In the suspicion of a hepatocellular carcinoma, the nodule was surgically removed, and the patient’s postoperative course was unremarkable. The final histopathological diagnosis was of adrenal rest tumor of the liver. Conclusions Hepatic adrenal rest tumor is an extremely rare hepatic tumor, often without any clinical manifestation, that can also occur in the cirrhotic liver as in our case. Although there are not specific imaging findings, the possible diagnosis of HART should be considered when we observe a well-defined lesion in the subcapsular location of the right lobe, with fat containing, hypervascularity after contrast medium injection and vascular supply from the right hepatic artery.Piero BoraschiFrancesca TuriniFrancescamaria DonatiFrancesca PeruzziAnnamaria BartolucciNiccolò RoffiPiero ColombattoLucio UrbaniSpringerOpenarticleHepatic adrenal rest tumorLiverLiver neoplasmsCTMR imagingMedical physics. Medical radiology. Nuclear medicineR895-920ENThe Egyptian Journal of Radiology and Nuclear Medicine, Vol 52, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Hepatic adrenal rest tumor Liver Liver neoplasms CT MR imaging Medical physics. Medical radiology. Nuclear medicine R895-920
spellingShingle	Hepatic adrenal rest tumor Liver Liver neoplasms CT MR imaging Medical physics. Medical radiology. Nuclear medicine R895-920 Piero Boraschi Francesca Turini Francescamaria Donati Francesca Peruzzi Annamaria Bartolucci Niccolò Roffi Piero Colombatto Lucio Urbani Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation
description	Abstract Background Adrenal rest tumor is an ectopic collection of adrenocortical cells in an extra-adrenal site, more frequently located around the kidney, retroperitoneum, spermatic cord, para-testicular region and broad ligament, but very rarely occurring also in the liver. Hepatic adrenal rest tumor poses a diagnostic challenge in differentiating it from hepatocellular carcinoma, particularly in a cirrhotic liver. Case presentation An 83-years-old male was referred to our hospital by his family doctor for hepatological evaluation due to multifactorial liver cirrhosis. Ultrasound revealed a centimetric hypoechoic nodule in the VI hepatic segment in the context of a liver with signs of cirrhosis and steatosis. The patient first underwent MRI and then CT, which showed a fat containing focal liver lesion in the subcapsular location of the right lobe, strictly adjacent to the homolateral adrenal gland. The nodule was hypervascular in the arterial phase, washed out in the portal-venous and transitional phases, resulting hypointense in the hepato-biliary phase at MR imaging. In the suspicion of a hepatocellular carcinoma, the nodule was surgically removed, and the patient’s postoperative course was unremarkable. The final histopathological diagnosis was of adrenal rest tumor of the liver. Conclusions Hepatic adrenal rest tumor is an extremely rare hepatic tumor, often without any clinical manifestation, that can also occur in the cirrhotic liver as in our case. Although there are not specific imaging findings, the possible diagnosis of HART should be considered when we observe a well-defined lesion in the subcapsular location of the right lobe, with fat containing, hypervascularity after contrast medium injection and vascular supply from the right hepatic artery.
format	article
author	Piero Boraschi Francesca Turini Francescamaria Donati Francesca Peruzzi Annamaria Bartolucci Niccolò Roffi Piero Colombatto Lucio Urbani
author_facet	Piero Boraschi Francesca Turini Francescamaria Donati Francesca Peruzzi Annamaria Bartolucci Niccolò Roffi Piero Colombatto Lucio Urbani
author_sort	Piero Boraschi
title	Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation
title_short	Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation
title_full	Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation
title_fullStr	Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation
title_full_unstemmed	Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation
title_sort	hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with ct and mri findings and pathologic correlation
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/3c448d1e43fb470fb08cbb37762411d7
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Hepatic adrenal rest tumor in a patient with multifactorial liver cirrhosis: a case report with CT and MRI findings and pathologic correlation

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