Multifocal Nodular Lesions in Fatty Liver Mimicking Neoplastic Disease: a Case Report

Abstract

Usually, fatty hepatic infiltration is diffuse and homogeneous. However, in some cases, it can be localized simulating benign or malignant tumors. We present a case of a 61-year-old female patient with family history of malignancy: sister with lung cancer, an other sister with colon cancer and a mother with breast cancer; who presented with multiple hepatic nodules at the ultrasonography images. CT scan and MRI were not sufficient to pose a certain diagnosis which was later confirmed by liver biopsy.

Radiopathologic findings of multifocal nodular hepatic steatosis

“…The patients in this study included both males and females with differing underlying medical comorbidities. Patients are often asymptomatic with normal laboratory findings work, including LFTs [ 2 , 4 , 5 ], and are found incidentally on imaging done for other clinical indications [8] . The multinodular presentation of MFNHS on imaging can easily be misidentified as primary or secondary hepatic malignancies, leading to additional diagnostic workup and undue patient distress.…”

“…On pathology, MFNHS presents as circumscribed non-encapsulated focal infiltrates composed of macroscopic fat. There is no vascular involvement, and the surrounding parenchyma displays variable amounts of inflammation and fibrosis [ 8 , 12 ]. The natural history of MFNHS is quite variable.…”