Benign hepatic lesions in women taking oral contraceptives
With the advent of whole body computed tomography (CT), an early diagnosis of hepatic tumors may be posible and laparotomy for diagnosis unnecessary. The CT scanner used was the whole body Delta unit. Patients were examined after an iv dose of 100 cc of Renograffin 60. Solid and cystic components of lesions can thus be determined. Case reports are given of 2 patients. The 1st patient had been taking Ovulen-21 for 21 months. Her liver scan revealed a large filling defect in the right lobe of the liver. Abdominal angiography showed an avasuclar mass displacing the right kidney. A CT scan depicted a large mass replacing the right lobe of the liver. The density of the mass indicated a fluid-filled cyst. At laparotomy a cyst involving the entire right lobe of the liver was found. Several nodules were present in the cyst wall. The diagnosis was cyst-adenoma of the liver. The other patient had taken Ovulen-21 for 7 years. An enlarged liver and symptoms of cholecystitis were present. The CT scan revealed a bolbous mass in the right lobe of the liver. The tumor was of the same density as the liver. At laparotomy a large hepatic adenoma was found. A 2nd mass was present in the left lobe. The tumors were not resected; cholecystectomy was done. Because of bleeding, a hepatic artery was ligated. Postoperatively, a repeat CT scan showed a large area of decreased density. At reoperation a large hematoma with necrosis of the hepatic adenoma was found and drained. The CT is an accurate method of performing percutaneous biopsies and aspiration procedures. An exact position of the needle tip can be obtained. CT-guided biopsies have also been done on masses in other areas.