Multiple focal nodular hyperplasia and steatosis: Atypical imaging characteristics

Focal nodular hyperplasia is a rare, benign condition of the liver. A 28-ye ar-old woman with malignant melanoma, mild liver enzyme abnormalities, stea tohepatitis and newly documented hepatic lesions is described. Ultrasound c omputed tomography and magnetic resonance imaging suggested only areas of f ocal fatty sparing but could not eliminate the concern for metastases. A (9 9m)technetium-labelled sulphur colloid scan, however, revealed areas of inc reased uptake consistent with multiple local nodular hyperplasia. This diag nosis was ultimately confirmed with a liver biopsy. The investigation of a patient with a malignancy and expanding hepatic lesions is challenging. Thi s cast illustrates the usefulness of the (99)mtechnetium-labelled sulphur c olloid scan in the evaluation of patients with hepatic lesions.