Hemorrhagic Hepatic Cyst mimicking a Biliary Neoplasm in a patient with Polycystic Liver Disease: Report of a Case with emphasis on Contrast-Enhanced Ultrasound with SonoVue®

The occurrence of intracystic hemorrhage in benign liver cysts is usually seen in huge solitary cysts and in older individuals. We report a case of multiple simple hepatic cysts with intracystic hemorrhage complicating one of the cysts in whom the correct diagnosis was accurately made by Contrast-Enhanced Low-MI Real-Time Ultrasound (CEUS) Imaging with Sonovue® (Bracco, Milano, Italy). Our report emphasize on the crucial role of CEUS as imaging modality in providing the informations needed to differentiate haemorragic cysts from cystic liver tumors such as cystadenoma and cystadenocarcinoma, potentially avoiding the use of more invasive and expensive imaging modalities such as CT or MRI imaging.