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Successful Treatment of Hepatocellular Adenoma with Percutaneous Radiofrequency Ablation

Thomas D. Atwell1, David J. Brandhagen2, J. William Charboneau1, David M. Nagorney3, Matthew R. Callstrom1 and Michael A. Farrell1

1 Department of Diagnostic Radiology, Mayo Clinic College of Medicine, 200 1st St. SW, Rochester, MN 55905.
2 Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN.
3 Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN.



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Fig. 1A. —32-year-old otherwise healthy woman admitted to hospital after acetaminophen overdose. Subsequent sonography showed indeterminate liver mass. CT scan after IV contrast enhancement shows 3.1-cm hypoenhancing mass in left lobe of liver.

 


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Fig. 1B. —32-year-old otherwise healthy woman admitted to hospital after acetaminophen overdose. Subsequent sonography showed indeterminate liver mass. Longitudinal sonogram of liver obtained during course of radiofrequency ablation shows early liberation of gas at ends of electrode tines (arrows).

 


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Fig. 1C. —32-year-old otherwise healthy woman admitted to hospital after acetaminophen overdose. Subsequent sonography showed indeterminate liver mass. CT scan of liver with IV contrast enhancement performed 17 months later shows retraction of ablation scar and no evidence of recurrent adenoma.

 


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Fig. 2A. —48-year-old woman with history of oral contraceptive use and unrelated inflammatory muscle disorder. Axial MRI images using in- (A) and out-of-phase (B) imaging shows considerable signal dropout (arrow, B) in otherwise invisible mass in right lobe of liver.

 


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Fig. 2B. —48-year-old woman with history of oral contraceptive use and unrelated inflammatory muscle disorder. Axial MRI images using in- (A) and out-of-phase (B) imaging shows considerable signal dropout (arrow, B) in otherwise invisible mass in right lobe of liver.

 


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Fig. 2C. —48-year-old woman with history of oral contraceptive use and unrelated inflammatory muscle disorder. Longitudinal sonogram of liver shows hyperechoic 2.4-cm mass (arrow) confirmed to be hepatocellular adenoma at biopsy.

 


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Fig. 2D. —48-year-old woman with history of oral contraceptive use and unrelated inflammatory muscle disorder. Longitudinal sonogram obtained during course of radiofrequency ablation shows echogenic tines (arrows) of umbrella-type electrode that encompass adenoma.

 

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