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Hepatic Capsular Retraction in Metastatic Carcinoma of the Breast Occurring with Increase or Decrease in Size of Subjacent Metastasis

Fiona M. Fennessy1, Koenraad J. Mortele1, Thomas Kluckert2, Adheet Gogate1, Silvia Ondategui-Parra1, Pablo Ros1 and Stuart G. Silverman1

1 Department of Radiology, Division of Abdominal Imaging and Intervention, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115.
2 Institute for Radiology, Rorschacherstrasse 95, Kantonsspital St. Gallen, St. Gallen 9007, Switzerland.



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  		Fig. 1. —Bar chart shows changes in size of metastases in patients with (white bars) and without (black bars) hepatic capsular retraction. Note moderately strong correlation between capsular retraction and decrease in size ({rho} = 0.46, p < 0.05). Correlation between retraction and increase in size of metastases is not as strong ({rho} = 0.32) but remains statistically significant (p < 0.05). There is significant correlation between capsular retraction and increase, decrease, or overall change in size.

 


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  		Fig. 2A. —42-year-old woman with breast cancer metastatic to liver. Axial contrast-enhanced CT scan shows multiple low-attenuation lesions scattered throughout liver. Note lack of appreciable capsular retraction.

 


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  		Fig. 2B. —42-year-old woman with breast cancer metastatic to liver. Axial contrast-enhanced abdominal CT scan obtained 6 months after A shows that lesions are smaller. Note capsular retraction and ascites.

 


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  		Fig. 3A. —59-year-old woman with breast cancer metastatic to liver. Axial contrast-enhanced CT scan shows 14 x 15 mm low-attenuation hepatic metastasis (arrow) at inferior liver tip. Note lack of capsular retraction.

 


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  		Fig. 3B. —59-year-old woman with breast cancer metastatic to liver. Axial contrast-enhanced abdominal CT scan obtained 3 months after A shows lesion increased to 27 x 26 mm. Note capsular retraction (arrow).

 

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