Presentation
Incidental finding during routine MRI liver for iron deposition in a setting of beta thalassemia major and transfusion-related iron overload.
Patient Data
Incidental finding of an elongated left lobe of the liver. The left lobe extends far laterally to completely surround the stomach and superior pole of the spleen.
There is an incidental, simple, intrasplenic cyst.
There is no hepatosplenomegaly and no evidence of developing cirrhosis in view of the history.
(Note: limited images have been uploaded)
Case Discussion
Elongation of the left lobe of the liver is a normal anatomical variant and is also known as a beaver tail liver. It is of no pathological consequence however, sometimes it may have clinical implications. It may contribute to a confusing CT or ultrasound appearance and lead to a misdiagnosis of left lobe hepatomegaly, splenomegaly, perisplenic or subscapular splenic hematoma in a setting of abdominal trauma. It can also be reported as a left lobe or splenic mass when one is unaware of this normal variant 1.
The use of color Doppler during ultrasonography may assist in identifying normal hepatic and portal vessels and aid in confirming a beaver tail liver and the absence of any splenic pathology 1.
(In this patient T2 relaxometry confirmed light iron deposition in the spleen and pancreas.)
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