Insulinoma liver metastases with surrounding focal fat

Contributed by: Ed Boas

Hypervascular liver lesions are consistent with insulinoma metastases.  The surrounding hypodensity is consistent with focal fat, likely secondary to insulin secretion by the metastasis.

Common hypervascular liver metastases: neuroendocrine tumor, thyroid carcinoma, renal cell cacinoma, melanoma.  These tumors enhance more than the liver on the arterial phase, and like HCC, they can show washout (hypodense compared to liver) on a delayed phase.