A Controversial Case of a Double Hepatic Incidentaloma in a Male Patient with Kidney Failure

Abstract

Hepatic incidentalomas are incidentally lesions detected during investigations for other pathologies. We describe a pre-dialysis kidney failure male patient case. During abdominal ultrasound exam, two hypoechoic lesions were found. The non-univocal results of contrast enhancement ultrasound and magnetic resonance suggested the diagnosis of hepatic adenoma, but required further examinations. The liver biopsy showed cellular atypia compatible with both hepatic adenoma and differentiated hepatocellular carcinoma. Transient elastography indicated the absence of significant fibrosis. According to this data, we have leant towards benign hepatic lesions, because the presence of hepatocarcinoma in a non-cirrhotic liver is unlikely to be verified.