AUTHOR=Li Guoan , Hong Shengqian , He Tao , Xu Jianbo 

TITLE=Case Report: Whispers of the serpent: exploring uncommon imaging features in primary hepatic malignant mesothelioma

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1713971

DOI=10.3389/fmed.2025.1713971

ISSN=2296-858X

ABSTRACT=Primary hepatic malignant mesothelioma (PHMM) is an uncommon and aggressive neoplasm with vague clinical and radiological features, posing challenges for preoperative diagnosis. In our case, a lobulated hepatic mass demonstrated a serpiginous peripheral enhancement pattern on contrast-enhanced CT and MRI. This uncommon imaging manifestation has been sporadically documented in previous reports. By consolidating these findings, our report emphasizes serpiginous peripheral enhancement as a potential diagnostic clue for PHMM. Recognition of this pattern may aid earlier detection, improve differential diagnosis, and guide timely surgical decision-making in affected patients.