technetium-tc-99m-disofenin and Hamartoma

We report a 61-year-old asymptomatic man who had a hepatic lesion whose nature was undetermined, based on biochemistry, serology, ultrasonography, computed tomography, and magnetic resonance imaging studies. Biliary hamartomas were diagnosed by echo-guided needle biopsy. Functional studies of bile excretion, using 99mTc-diisopropyl iminodiacetic acid (99mTc-DISIDA) scintigraphy liver single-photon emission computed tomography (SPECT) showed the delayed transit of tracers from hepatocytes to the biliary hamartomas and the delayed emptying of tracers to the neighboring bile ducts. Therefore, biliary hamartomas should be included in the differential diagnosis of single or multiple hepatic lesions whose nature is undetermined, and a liver biopsy would be warranted for further treatment plans. We believe this is the first functional study of bile excretion in biliary hamartomas using radionucleotide studies; such studies may have prognostic implications.

Topics: Bile Acids and Salts; Bile Duct Diseases; Biopsy, Needle; Follow-Up Studies; Hamartoma; Humans; Image Enhancement; Immunohistochemistry; Male; Middle Aged; Risk Assessment; Sensitivity and Specificity; Technetium Tc 99m Disofenin; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Treatment Outcome