AUTHOR=Yıldırım Murat Baki , Şahiner İbrahim Tayfun , Poyanlı Arzu , Acunaş Bülent , Güllüoǧlu Mine , İbiş Cem , Tekant Yaman , Özden İlgin 

TITLE=Malignant Tumors Misdiagnosed as Liver Hemangiomas

JOURNAL=Frontiers in Surgery

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.715429

DOI=10.3389/fsurg.2021.715429

ISSN=2296-875X

ABSTRACT=Background and Aim: To derive lessons from the data of patients who were followed for various periods with the misdiagnosis of liver hemangioma and eventually found to have a malignancy.  
Material and methods:  The records of 23 patients treated between 2003 and 2018 were analyzed retrospectively.   
Results: Twelve patients were men and 11 were women; median (range) age was 55 (35-80). The principal diagnostic modality for the initial diagnosis was ultrasonography (n:8), magnetic resonance imaging (MRI) (n: 13) and computed tomography (CT) (n: 2). At our institution, MRI was performed in 16 patients; the diagnosis was made with the available MRI and CT studies in 5 and 2 patients respectively. In other words, the ultrasonography interpretations were not confirmed on MRI; in others, the MRI or CT examinations were of low quality or they had not been interpreted properly. Fifteen patients underwent surgery; the other patients received chemotherapy (n:6) or chemoembolization (n:2). The misdiagnosis caused a median (range) 10 (0-96) months delay in treatment.   The final diagnoses were hepatocellular carcinoma in 12 patients, cholangiocarcinoma in 4 patients, metastatic mesenchymal tumor, metastasis of colon cancer, metastatic neuroendocrine carcinoma, sarcomatoid hepatocellular carcinoma, angiosarcoma, thoracic wall tumor and metastatic tumor of unknown primary in one patient each.  
Conclusions: High-quality MRI with proper interpretation and judicious follow up are vital for the accurate differential diagnosis of liver lesions.