Radiotherapy is frequently used for the treatment of pediatric abdominal tumors. If the liver is incidentally included in the treatment port, the irradiated segments may become small and fibrotic, whereas the unirradiated segments are hypertrophic. A 35-year-old woman who had a right adrenalectomy for neuroblastoma at the age of 1 year is presented. Her treatment included radiation of the tumor bed. The exact radiation port and dosage are unknown. The patient had findings suggestive of acute cholecystitis. Hepatobiliary imaging was performed, and although biliary function was normal, there was an unusual mass-like configuration of the left lobe of the liver that accumulated both Tc-99m DISIDA and sulfur colloid. An abdominal CT showed this mass to be hypertrophy of the left lobe of the liver associated with atrophic changes of the right-sided abdominal organs and musculature in the region of the previously irradiated right adrenal bed.
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