Sonographic appearance of lipoma of the inferior vena cava

Lipomas of the major central veins are rare, and their sonographic features have rarely been reported. We report a case in which a lipoma of the infer ior vena cava (IVC) was incidentally identified during liver sonography in a 68-year-old man. Sonography of the upper abdomen revealed coarsening of t he liver echotexture, with a relatively small liver and atrophy of the righ t hepatic lobe. A 2-cm hypoechoic hepatic nodule was visualized in segment IV. Sonography also showed a 2.2- x 1.8-cm, highly echogenic, homogeneous n odule in the hepatic segment of the IVC at its junction with the right atri um. The lumen of the IVC was partially occluded. The CT and MRI appearances of the IVC lesion were consistent with a lipoma, which was not treated bec ause there was no clinical evidence of obstruction. Histopathologic analysi s following a sonographically guided biopsy of the liver nodule revealed he patocellular carcinoma, which was treated by percutaneous ethanol injection . (C) 2001 John Wiley & Sons, Inc.