Hepatomegaly due to metastases

Liver metastases. The liver appears hugely enlarged on this abdominal radiograph. The clue to the underlying pathology is in the pelvis – the tiny linear metal rods in the middle of the lower pelvis are called ‘brachytherapy’ rods (or seeds). These contain a radioactive substance (for example, iodine 125), and are inserted into the prostate as a treatment for prostate cancer. The coronal CT image shows that the hepatomegaly in this case is due to a large number of low attenuation lesions, which were metastases from prostate cancer. This is a relatively uncommon site of metastatic disease in prostate cancer – in most cases, metastases will be confined to the bones and pelvic/retroperitoneal lymph nodes.