Male Patient 30 years of age, having right flank pain send for Ultrasound —— US showed a 12 mm calculus in Rt.kidney——-and mildly enlarged Fatty liver with is incidental finding of this hypoechoic lesion —– what could be??
Many options here.
There is hepatic steatosis so an area of focal fatty sparing is an option although not my most favoured. The enhancement behind it raises the possibility of an atypical haemangioma. FNH, adenoma, HCC and metastatic disease are all possible. CT or MRI are going to be helpful. Contrast enhanced ultrasound is also a good option, although we don’t offer this service.
I would agree, Cav Haemangioma is my first differential. There is some acoustic enhancement. The liver looks quite fatty and I think it certainly requires other imaging for a difinitive diagnosis.