Diffuse hepatocellular carcinoma with malignant portal vein thrombosis and arterioportal shunt
Presentation
Background of liver cirrhosis presenting with progressive abdominal enlargement
Patient Data
There is diffuse malignant infiltration of the medial segments of left and right hepatic lobes. There is early filling of right and left portal vein branches in the arterial phase suggesting underlying arterio-portal shunting which is associated with infarction of the lateral segment of left hepatic lobe from steel phenomenon. Moreover there is malignant thrombosis of the right and left portal vein branches reaching the confluence. Marked ascites is detected.
Diagnosis: Diffuse hepatocellular carcinoma with malignant portal vein thrombosis and arterio-portal shunt
Case Discussion
Alpha fetoprotein of the patient was 1120 ng/dL which correlated with hepatocellular carcinoma. The washout of the lesion was not apparent on portovenous phase may be from hemodynamic alteration by arterioportal shunt.
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