Unusual Uptake of 18FDG by a Hepatic Adenoma

Abstract

Hepatic adenoma is a rare, benign tumor (with potential for malignant degeneration) and its diagnosis is difficult because its presentation is highly variable in medical imaging, particularly with MRI. In such cases, the use of a hepatic biopsy is usually recommended. (18)FDG-PET/CT provides a very significant predictive value for malignant hepatic lesions. In addition, the occurrence of an (18)FDG-avid benign tumor is a rare event. We hereby present the case of a patient with advanced breast cancer for whom an (18)FDG-PET/CT showed a focal hepatic uptake. A subsequent biopsy provided a diagnosis of a hepatic adenoma.

PET-avid hepatocellular adenomas: incidental findings associated with HNF1-α mutated lesions

“…In the literature, there are 7 previously published reports of 10 patients with FDG-avid HCA, including a small case series. [25][26][27][28][29][30][31] Patel et al first reported this observation in 1997. 25 All the patients in the previous reports are female with age ranging from 34 to 65 years old.…”

False-positive 18F fluorodeoxyglucose positron emission tomography-avid benign hepatic tumor: Previously unreported in a male patient

“…Previous case reports or case series in the literature either have shown PET-avid adenomas in female patient mostly with HNF-1-α mutation or with no detail pathological analysis. [ 1 2 3 4 5 6 7 8 ] Single case report of HNF-1-α mutated PET-avid HCA has been reported in a male who had a history of testosterone usage for a year. [ 1 ]…”

Pet/Mri:

“…MRI is the study of choice for evaluation of most liver lesions, given its ability via dynamic contrast enhancement and DWI to distinguish a range of benign and malignant pathologies with a high level of accuracy. Because both malignant and benign liver lesions (e.g., adenomas) can be hypermetabolic and thus can mimic metastatic disease, hepatic lesions deemed indeterminate on PET/CT are often referred to MRI for further evaluation (58). As the liver is a common site of tumor spread, especially for primary gastrointestinal cancers such as colorectal carcinoma, there has been considerable interest in examining the role of PET/MRI in the diagnosis of hepatic metastases.…”