Fat within hepatic hydatid cyst – a case report
Section
Abdominal imaging
Case Type
Clinical Cases
Authors
Amol Gulhane, Rashmi Kotkar, Madhuri Ghate
Krsna Diagnostics PVT LTD; Pawana Nagar Housing Society 411033 Chinchwad, India; Email:madhuri.ghate01@gmail.com
Patient
55 years, female
Categories
Procedure Education ; Special Focus Neoplasia ;
FIGURE 1
Axial non contrast CT image
Axial non-contrast CT image shows well-defined cyst in segment VIII of the liver with wall calcification (white arrow) and intracystic fat globules (red arrow).
Clinical History
A 55-year-old female patient presented with complaints of abdominal pain in the right hypochondrium for 1 year. On USG two complex multiloculated cystic lesions were noted, one in each segment VII and VIII of the liver. CECT abdomen was advised for further evaluation.
Imaging Findings
A rounded cystic lesion measuring approximately 74 mm (transverse) x 63 mm (AP) was noted in segment VIII of the right lobe of the liver. The lesion showed fluid density internal contents with fat density globules (red arrow) within. The cyst wall showed focal areas of dense calcification (white arrow). Another similar cystic lesion measuring approximately 62 x 62 mm was seen in segment VII of the liver. Thin septa (yellow arrow) was seen separating the two cysts. On a post-contrast scan the cyst wall showed mild enhancement. No evidence of a fat-fluid level. No evidence of any daughter cysts within. No features suggestive of cyst rupture or infection. No evidence of intrahepatic biliary radical dilatation or demonstrable cysto-biliary communication. The rest of the liver parenchyma appeared normal (Fig. 1 , 2 , 3). The findings were suggestive of hydatid cyst with possible degeneration.
Discussion
Differential Diagnosis List
Degenerating hepatic hydatid cyst showing fat globules and wall calcification.
Hepatic angiomyolipoma
Hepatic teratoma
Final Diagnosis
FIGURE 2
Axial CECT scan image
Axial CECT examination image shows a thin enhancing septa (yellow arrow) separating the two cysts with cyst wall calcification (white arrow) and intracystic fat globules (red arrow).
FIGURE 3
Sagittal reformatted CT image
Sagittal reformatted CT image showing cysts in segments VII and VIII of the liver with cyst wall calcification (white arrow) and intracystic fat globules (red arrow).