Femenina 28 años de edad cuyo examen sonografico de abdomen y pelvis por dolores abdominales difusos, muestra un aumento de la ecogenicidad hepática por su incremento a nivel de las ramificaciones portales ( higado estrellado) por ingesta de analgésicos. Se visualiza presencia de líquido ascítico. El riñón derecho se aprecia en localización ectópica por delante del 4to cuerpo vertebral lumbar. A nivel pélvico se visualiza masa heterogénea, compleja, mixta (solido-liquido) mide aprox: 7.90 X 3.14 cm con aumento del flujo al Doppler Color. Dado que la paciente es muy delgada pudimos aplicar, usando el transductor lineal de 10.0 MHz, la Elastografia en la pared engrosada de la masa (ver fotos 5-6) con lo cual se demostró un score 2-3 de Ueno con ratio B/A menor de 1 (0.83) sugestivo por tanto de lesión benigna. Se concluye con los diagnósticos de tumoración mixta probablemente benigna de ovario izquierdo, ascitis, ectopia renal derecha e higado estrellado. Debe recordarse que de estos diagnósticos el menos relevante es el higado estrellado ya que es benigno y reversible en cuanto deje de ingerir los analgésicos que lo producen.
Mixed Ovarian Tumor and Renal Ectopia and Stellated Liver
A 28-year-old female whose sonographic examination of the abdomen and pelvis due to diffuse abdominal pain shows an increase in liver echogenicity due to its increase in the level of the portal ramifications (stellate liver) due to the intake of analgesics. The presence of ascitic fluid is visualized. The right kidney can be seen in an ectopic location in front of the 4th lumbar vertebral body. At the pelvic level, a heterogeneous, complex, mixed (solid-liquid) mass is visualized, measuring approximately: 7.90 X 3.14 cm with increased flow on Color Doppler. Given that the patient is very thin, we were able to apply, using the 10.0 MHz linear transducer, Elastography on the thickened wall of the mass (see photos 5-6), which demonstrated an Ueno score of 2-3 with a B/ ratio. A less than 1 (0.83) therefore suggestive of a benign lesion. It concludes with the diagnoses of probably benign mixed tumor of the left ovary, ascites, right renal ectopy and stellate liver. It must be remembered that of these diagnoses the least relevant is stellate liver, since it is benign and reversible as soon as you stop taking the analgesics that produce it.
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