A 35-year-old woman with right upper quadrant pain undergoes ultrasound, which shows a well-defined hyperechoic homogeneous mass in segment VI of the liver. On contrast-enhanced ultrasound (CEUS), the lesion shows peripheral nodular enhancement in the arterial phase with progressive centripetal fill-in and complete fill-in in the late phase. The MOST likely diagnosis is:

• A Hepatocellular carcinoma
• B Hepatic adenoma
• C Focal nodular hyperplasia
• D Hepatic hemangioma ✓

Explanation

Hepatic hemangioma is the most common benign liver tumor and characteristically shows peripheral nodular enhancement with progressive centripetal fill-in on CEUS, CT, or MRI. HCC shows arterial hyperenhancement with washout, not centripetal fill-in. Adenoma shows heterogeneous enhancement without peripheral nodularity. FNH shows central scar with spoke-wheel arterial enhancement and rapid homogeneous fill-in, not peripheral nodular enhancement.

Reference: Diagnostic Imaging: Hepatobiliary and Pancreas (Federle), Standard edition ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.