Atypical Hepatic Hemangioma With Progressive Centrifugal Enhancement Pattern Mimicking Malignant Liver Lesion.

Hepatic hemangioma is a common benign vascular hepatic lesion with typical imaging features. However, hepatic hemangiomas with atypical radiological characteristics can sometimes be diagnostically challenging. Here, we report a case of an elderly patient with colonic adenocarcinoma who was incidentally found to have an atypical hepatic hemangioma showing a progressive centrifugal enhancement pattern instead of a typical centripetal pattern on contrast-enhanced computed tomography mimicking a malignant liver lesion.

Ethical dilemmas of a freshly graduated rural clinician in Kerala, India: a personal reflection.

Freshly graduated doctors are the lesser-known workhorses of the rural healthcare system in India. These rural clinicians confront numerous ethical dilemmas in their day-to-day life, which are quite different from the ethical issues they may have encountered during their medical training and internship at a tertiary care hospital. These include taking end of life decisions, breaking bad news, conflicts in the doctor-patient relationship, declaration of death, and counselling of patients or family attendants of terminally ill patients.