Calcified Liver Metastases

The differential diagnosis of calcified liver lesions includes benign and malignant causes. Benign causes include infectious conditions such as tuberculosis and echinococcus, as well as benign masses like hemangiomas. Malignant primary tumors such as hepatocellular carcinoma and cholangiocarcinoma can also cause calcifications.

Calcifications can also be associated with metastases from the following sources:

• Mucinous neoplasms: Colon is the most common, but mucinous neoplasms elsewhere in the gastrointestinal tract can also cause calcifications.
• Serous ovarian cystadenocarcinoma:
• Medullary thyroid carcinoma: Case shown above.
• Sarcomas: Osteosarcoma, leiomyosarcoma.
• Islet cell carcinoma of the pancreas:
• Breast carcinoma: While we're used to seeing calcification in the primary lesion, calcification in metastatic breast cancer is relatively uncommon.

References

• Appleby A, Hacking PM. Calcification in hepatic metastases. Br J Radiol. 1958 Aug;31(368):449-50.
• Katragadda CS, Goldstein HM, Green B. Gray scale ultrasonography of calcified liver metastases. AJR Am J Roentgenol. 1977 Oct;129(4):591-3.