Pelioid-type hepatocellular carcinoma masquerading as a hepatic hemangiomaon technetium-99m red blood cell scintigraphy

Technetium-99m red blood cell (RBC) scintigraphy is a very specific method to differentiate a hemangioma from other hepatic masses. The authors report a case of hepatocellular carcinoma that showed a focal area of increased u ptake on Tc-99m RBC SPECT in a 60-year-old man. Dynamic computed tomography and angiography revealed features of both hemangioma and hepatocellular ca rcinoma. Pathologic examination showed that the portion of the hepatocellul ar carcinoma that showed increased uptake on Tc-99m RBC scintigraphy had pe liosis, which is the likely cause of the radiotracer avidity.