Differential Diagnosis
- Single Most Likely Diagnosis
- Focal liver lesion (possibly a hepatocellular adenoma or a hemangioma) given the 17mm process in the liver with homogeneous contrast uptake in the arterial phase and some washout in the venous phase, but with contrast retention centrally. This warrants further evaluation for possible liver tumor.
- Other Likely Diagnoses
- Pelvic Congestion Syndrome (PCS) due to the presence of varicose veins in the pelvis related to the uterus, which could explain symptoms such as chronic pelvic pain.
- Deep Vein Thrombosis (DVT) or thrombosis of the ovarian vein, as indicated by the 11mm long thrombus in the left ovarian vein, although there is recanalization via collaterals.
- Do Not Miss Diagnoses
- Liver Cancer (Hepatocellular Carcinoma): Although the report mentions that malignancy cannot be excluded, it's crucial to rule out liver cancer due to its significant implications on prognosis and treatment.
- Ovarian Torsion or Other Gynecological Emergencies: Despite the presence of varicose veins suggesting Pelvic Congestion Syndrome, other acute conditions like ovarian torsion need to be considered, especially if the patient presents with acute pain.
- Rare Diagnoses
- Hepatic Arteriovenous Malformation (AVM): Given the characteristics of the liver lesion, although less likely, an AVM could be considered, especially if there are symptoms suggestive of abnormal blood flow.
- Budd-Chiari Syndrome: This condition, caused by thrombosis of the hepatic veins, could potentially explain some findings, although it's less likely given the specific details of the CT scan report.