Is capsular retraction a specific CT sign of malignant liver tumor?

Abstract

The aim of this study was to assess if a liver capsular retraction is a specific CT sign in malignant hepatic tumors. The authors reviewed retrospectively 320 hepatic CT scans obtained in 300 patients during a 3-year period. These patients presented with benign (n = 64) or malignant (n = 236) hepatic tumors. In 7 patients we found retraction of the capsule surrounding the tumor. All these tumors were histologically proven as malignant lesions: 4 metastases (none being chemically treated), 2 peripheral cholangiocarcinomas, and 1 epithelioid hemangioendothelioma. The prevalence of this sign was 2.18% (7 of 320) in this series. This capsular retraction pattern has never been found in hepato-cellular carcinomas (no fibrolamellar in this series) and benign lesions. Liver capsular retraction is an uncommon but specific (100%) sign in malignant hepatic tumors; however, a larger and prospective series is needed.

Capsular retraction: an uncommon imaging finding in hepatic inflammatory pseudotumour

“…Capsular retraction adjacent to hepatic tumours is uncommon, with a reported frequency of 2.0-2.8% [10], and is thought to be caused by tumoural necrosis and desmoplastic reaction [11].…”

Differentiation between true focal liver lesions and pseudolesions in patients with fatty liver: evaluation of helical CT criteria

“…Of these, capsular retraction was found in association with true lesions and also in association with pseudolesions. Capsular retraction has been reported to be very suggestive of the diagnosis of actual lesions, and some studies suggest that it can be more frequently found in cases of malignant neoplasms [35,36]. However, this finding can be found either in malignant tumours or in benign ones [37][38][39].…”

Hepatic metastases from gastric hepatoid adenocarcinoma: An unusual cause of capsular retraction of the liver

“…In addition, hepatic metastases from breast carcinoma were less likely because of a normal CA 15.3 serum level. Retraction of the liver capsule adjacent to hepatic tumor has been reported in a variety of primary malignant (intrahepatic cholangiocarcinoma, epithelioid hemagioendothelioma) and secondary hepatic tumors (neuroendocrine tumors) [5][6][7][8]. This finding can also be observed in untreated liver metastases from breast cancer that may result in lobulated contours and morphologic changes of the liver, displaying the so-called ''hepar lobatum'' pattern [9].…”