Focal liver lesion: early hypoenhancement in CEUS does not prove malignancy -not even in a cirrhotic liver. Demonstration of a rare benign cause

Purpose: In CEUS of focal liver lesions enhancement in the arterial phase and an early outwash during the portal venous phase usually indicates malignancy, whereas almost all benign lesions display a sustained contrast enhancement up to the late phase or behave like the surrounding liver tissue. A rare cause of a benign lesion with arterial enhancement and an early hypoenhancement is reported. Material and methods: A 75 year old patient who had suffered from epigastric pain for 3 months presented for an abdominal ultrasound. A diabetes mellitus type II and an arterial hypertension were known. The physical exam s…