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Fibrolamellar hepatocellular carcinoma

Case contributed by Ian Bickle
Diagnosis almost certain

Presentation

Upper abdominal discomfort, sent for cross sectional imaging following an abnormal ultrasound performed elsewhere.

Patient Data

Age: 65 years
Gender: Male

Large heterogenous mass in the left lobe of liver, with central necrosis.

No synchronous lesion or regional lymphadenopathy.

Large well defined heterogenous mass in the left lobe of liver, with internal appearance like striations.  No diffusion restriction and variably, largely only rim enhancement with washout and persistent delayed enhancement of the capsule with large non enhancing central necrosis.

No synchronous lesion.

No background hepatic cirrhosis.

Case Discussion

Fibrolamellar hepatocellular carcinoma is a histological subtype of hepatocellular carcinoma, which has a number of key differences in terms of epidemiology, appearances and survival outcomes.

This case was histological proven following an ultrasound guided biopsy.

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