Aortic aneurysm causing multiple liver scan defects

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A 73-year-old female was hospitalized because of weight loss and anemia. A 99m Tc sulfuncolloid liver scan obtained using a Seanle Pho/Gamma III HP camera demonstrated a prominent left lobe (fig. 1A) containing several defects. The night lobe appeared normal. A pancreatic scan was performed following intravenous administration of 250 pCi of 7tSe selenomethionine using a Picker 2C Dynacamena. The pancreas was more vertical than normal and a defect in the body of the pancreas was suspected (fig. 18). Therefore, the possibility of a primary pancreatic malignancy metastatic to the liver was considered, especially in view of the severe weight loss and anemia. An upper gastrointestinal series showed lateral displacement of the stomach by a large intraabdominal mass. The contrast aontognam (fig. 2) demonstrated a huge tortuous aortic aneurysm with large atheromatous plaques. Intramural calcifications were identified well beyond the opacified lumen, which indicated that a significant portion of the aneurysm did not fill with contrast material. A small midline upper abdominal incision was made. The left lobe of the liver was thin but otherwise grossly normal to palpation. A huge abdominal aontic aneurysm was found posterior to the left lobe. A wedge biopsy of the left lobe was taken and demonstrated a normal liver architecture microscopically. Because of the patient’s age and debility. no further surgery was contemplated and the patient was discharged.