A Giant Mass in the Liver: Is It Always Bad to be Fat?

Introduction: Hepatic lipomas are rare benign lesions of the liver with characteristic findings on imaging, which differentiate them from other more important tumors of the liver and prevent unessential invasive procedures. Case Presentation: A 62-year-old man with intense acute dyspnea referred to our emergency department in Imam Reza Hospital, Mashhad city, Iran. We performed initial diagnostic tests, Chest X-Ray (CXR), and non-contrast lung CT scan for further evaluation. Laboratory tests were in the normal range, but two well-defined lobulated masses with typical features of lipomas were noted on abdominal sections of plain CT scan in the patient’s liver. The aim of this report is to define the characteristic appearance of these benign neoplasms on imaging techniques and to help exclude some more prevalent hepatic tumors with similar appearances without invasive procedures. Conclusions: Although there are numerous fat-containing lesions in the liver and some have heterogeneous and atypical features, it is often possible to make a definitive diagnosis of hepatic lipomas based on their typical imaging features, including pure fat density on CT scan, well-defined margins, chemical shift artifact on MRI, etc.