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Large heterogeneous arterial enhancing mass in the left hepatic lobe with portal venous phase washout. The mass is diffusely infiltrating the liver and there is evidence of both portal vein and IVC invasion by enhancing tumour thrombus. Tumour thrombus extends into the right atrium.
Background features of cirrhosis and portal hypertension, including ascites, porto-systemic varices, and splenomegaly. Cavernous transformation of the main portal vein likely reflects an element of chronic thrombus/occlusion in addition to the more recent tumour in vein.