Giant hemangioma or metastatic disease of malignant gastrointestinal tumor? Diagnoses through ‘new-line’ therapy

Centripetal enhancement of liver lesions on MRI scanning is an almost specific finding in the diagnosis of benign hemangiomata. The ability of MRI to produce higher temporal resolution of dynamic measurements shows that malignant liver lesions can also demonstrate centripetal enhancement. We report here a case of a malignant gastrointestinal stromal tumor (GIST) with a huge hepatic metastatic lesion of undetermined origin. During therapy with Imatinib (Glivecgr0300050x.gif ○r, Novartis, Basel, Switzerland), a highly selective tyrosine kinase inhibitor, the lesion shrank markedly and exhibited changes in contrast enhancement.