A 34-year-old woman has a 3 cm liver lesion found incidentally. Contrast MRI shows intense homogeneous arterial enhancement with progressive centripetal fill-in on delayed phases and a central area matching blood pool signal. She is completely asymptomatic and not pregnant. The most appropriate management is:
- A Ultrasound-guided core needle biopsy
- B No treatment, with imaging follow-up ✓
- C Transarterial embolization
- D Laparoscopic wedge resection
Correct answer: B. No treatment, with imaging follow-up
Explanation
Peripheral nodular discontinuous enhancement with progressive centripetal fill-in and blood pool signal intensity is diagnostic of cavernous hemangioma, the most common benign liver tumor. Asymptomatic hemangiomas under 5 cm require no intervention beyond reassurance, with occasional follow-up imaging. Biopsy risks serious hemorrhage and is contraindicated once characteristic imaging is present, and neither resection nor embolization is justified for a small asymptomatic lesion.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.