Presentation
Treated type 1 A HCV undergoes screening ultrasound of the liver for HCC every 6 months. AFP at diagnosis 7.0 ng/mL ( ref <6.1 ng/mL ).
Patient Data
There is a new echogenic lesion in the liver concerning for a neoplasm, recommend multiphasic CT scan of the liver.
Confirms a mass in segment IVa of the liver, not characteristic for a hemangioma. MRI was recommended.
The lesion in segment IVa demonstrates rim-enhancement concerning for malignancy not necessarily HCC, biopsy recommended.
Thanks to Dr.Lakshmi Vemavarapu MD for the pathology description of the HCC.
Case Discussion
The patient was referred to a hepatologist and a hepatic surgeon for further management.
SH-HCC is a frequent variant of HCC in NAFLD patients and HCV patients. As a radiologist you will see above fatty features in CT, MRI and on sonogram. So have a low threshold for biopsy and evaluation when in doubt.