The role of red blood cell scintigraphy in the multiple-modality imaging diagnosis of a rare case of diffuse hepatic hemangiomatosis in an adult

Introduction: Angiomas are one of the most common primary tumors of the liver. Diffuse hepatic angiomatosis, however, is quite rare and usually observed in pediatric patients. We report a rare case of diffuse hepatic hemangiomatosis in a 33-year-old woman.
Case report: The patient presented with abdominal pain and a palpable upper abdominal mass. Abdominal CT and magnetic resonance imaging (MRI) findings suggested diffuse hepatic hemangiomatosis, but this finding was not confirmed by subsequent contrast-enhanced abdominal ultrasonography (US). The patient then underwent single photon emission computed tomography (SPECT)/CT scintigraphy with Tc-99m-labeling of red blood cells (RBC). This examination revealed increased uptake of labeled erythrocytes in several of the hepatic lesions corresponding to CT and RM findings, thereby confirming the clinical hypothesis of diffuse hepatic hemangiomatosis.
Discussion: RBC scintigraphy with SPECT/CT can facilitate the comparison of other crosssectional imaging methods such as CT and MRI. This case highlights the importance of a multiple-modality approach in the imaging diagnosis of this condition.