Giant Hepatic Artery Aneurysm

Abstract

Hepatic artery aneurysm (HAA) is the second most common type of visceral aneurysm. Giant HAAs (larger than 5 cm) are very rare. We present a case of an asymptomatic giant hepatic artery aneurysm (diameter 10.7 cm) discovered as an incidental finding on an ¹⁸F-fludeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) scan of a patient admitted for pretreatment staging of urothelial carcinoma.

Keywords: 18F-Fludeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT); giant hepatic artery aneurysm (HAA).

Figure 1

(A) A coronal non-contrast enhanced computed tomography (CT) image of the lesion (red arrow). (B) A coronal fused positron emission tomography/computed tomography (PET/CT) image showing the same region with mild ¹⁸F-FDG uptake (red arrow). (C) A transverse non-contrast CT image confirming the presence of a cyst-like lesion with a hyperdense wall at the hepatic hilum, measuring approximately 107 × 105 mm. (D) A transverse fused PET/CT image demonstrating mild hypermetabolic activity in the center of the lesion compatible with blood pool activity (red arrows) and surrounding mural thrombus.

Figure 2

(A) Transverse grey-scale ultrasound of the porta hepatis reveals a large, well-defined sonolucent mass measuring approximately 9.7 × 9.4 × 9.1 cm. The upper part of the lesion shows an anechoic lumen, and the lower part of the lesion contains intraluminal echogenic material suggestive of thrombus. (B) Transverse color Doppler ultrasound shows a turbulent arterial flow pattern in the upper part of the lesion. (C) Pulsed wave Doppler sonogram shows an arterial waveform with high peak systolic velocity consistent with a hepatic artery aneurysm.