Key result
Post-pancreatectomy focal fatty change mimics hypervascular liver tumors on imaging via arterial hyperenhancement and washout.
Why the study?
Focal fatty change can exhibit various patterns, making differentiation from metastatic liver tumors challenging in patients with a history of treatment for malignant tumors.
Case Report (n=1)
No
Focal fatty change in the liver after total pancreatectomy can present with arterial-phase hyperenhancement and washout patterns, mimicking hypervascular liver tumors like hepatocellular carcinoma or metastases.
Consider focal fatty change in HCC-mimicking liver lesions post-total pancreatectomy; extends recognized benign causes of arterial hyperenhancement and washout.
Summary: Focal fatty change (FFC) can exhibit various patterns. Therefore, multifocal cases may require differentiation from metastatic liver tumors because the diagnosis is challenging in case of a history of treatment for malignant tumors. Herein, we report the case of a 65-year-old man with FFC who underwent total pancreatectomy for advanced intraductal papillary mucinous carcinoma. In this case, regular replacement of the percutaneous transhepatic cholangial drain was performed for postoperative anastomotic stenosis. The FFC showed a multifocal pattern with arterial-phase hyperenhancement and washout patterns; therefore, differentiation from not only metastatic liver tumors but also from hypervascular liver tumors including hepatocellular carcinoma was required. This case report highlights that although FFC can have a variety of imaging patterns; it can present arterial-phase hyperenhancement and washout patterns.
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Okamura et al. (2026) conducted a case report in Focal fatty change mimicking hypervascular liver tumor (n=1). Total pancreatectomy was evaluated on Diagnosis of liver nodules. Focal fatty change after total pancreatectomy can present with arterial-phase hyperenhancement and washout patterns on imaging, mimicking hypervascular liver tumors like hepatocellular carcinoma.
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