Telangiectatic adenoma - computed tomography and magnetic resonance findings: a case report and review of the literature

Abstract

Telangiectatic adenoma is a new classification of a hepatic lesion. It was previously named telangiectatic focal nodular hyperplasia but it is in fact true adenoma with telangiectatic features. We report here a case of telangiectatic adenoma in a 72-year-old woman. The image features are lack of a central scar, a heterogeneous lesion, hyperintensity in T1-weighted MR images, strong hyperintensity in T2-weighted MR images, and persistent contrast enhancement in delayed-phase contrast-enhanced CT or T1-weighted MR images. It is a monoclonal lesion with potential of malignancy. The treatment of telangiectatic adenoma is surgery, the same way as hepatic adenoma. Focal nodular hyperplasia may be managed by clinical follow-up alone.

Figure 1

Portal-stage contrast-enhanced helical CT of the upper abdomen. Impregnation by the contrast agent shows a large, solid, exofitic lesion compromising the left liver lobe. The enhancement is intense and heterogeneous, the dominant portion being in the periphery of the lesion (arrow).

Figure 2

MR imaging sequence with T2-weighted transversal. Imaging shows a hypointense signal originating in the peripheral region (arrow) and a dominant component associated with a hyperintense signal (*).

Figure 3

(A) T1-weighted fat-suppressed MR imaging without contrast; and MR imaging after contrast in (B) arterial phase, (C) portal phase, and (D) late phase. In T1-weighted images without contrast, the signal in the periphery of the mass (arrow) is similar to the muscle signal; the center of the lesion clearly shows a hypointense signal (*). Although impregnation of both components began in the arterial phase, the peripheral region (arrow) showed a stronger signal during the arterial and portal phases, followed by signal decay in the late phase due to relatively rapid washout, indicative of hypervascularization. The enhancement of the central component is far more intense in the late phase (*), probably due to a large interstitial space and slow flow through the vascular components.