A hypervascular pseudotumor in the liver with angiodysplasia in the center of the lesion: A new entity or a variant of focal nodular hyperplasia?

A unique case of hypervascular pseudotumor in the liver consisting of central angiodysplasia surrounded by atrophic liver tissue is described. A 45-year-old woman was referred for the incidentally found hepatic lesion. Computed tomography with contrast showed strong enhancement of the lesion in the arterial phase, and the effect persisted to the parenchymal phase. Doppler ultrasonography showed winding dilated blood flows into the lesion. Because the pathological examination of the biopsy specimen showed the possibility of a well-differentiated hepatocellular carcinoma, she underwent surgery. Final pathological findings showed that the lesion demonstrated atrophic change of the liver tissue with a cluster of abnormal vessels of various sizes in the center. Although there was no primary liver disease, multiple liver metastases from laryngeal carcinoma were found coincidentally. The present lesion could represent a new entity or a variant (or an unknown stage of development) of focal nodular hyperplasia.