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

## TL;DR

This case report highlights a rare liver tumor with unique imaging features that could help diagnose it earlier.

## Contribution

The report identifies serpiginous peripheral enhancement as a novel imaging clue for primary hepatic malignant mesothelioma.

## Key findings

- A lobulated hepatic mass showed serpiginous peripheral enhancement on CT and MRI.
- This imaging pattern may aid in the early detection and diagnosis of PHMM.
- Recognizing this pattern can improve differential diagnosis and surgical decision-making.

## 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.