Atypical hepatocellular carcinoma

Case contributed by Tommaso Buzzegoli
Diagnosis probable


Admitted after a spontaneous deep vein thrombosis. Laboratory showed leukocytosis and elevation of CRP, a screening abdominal CT was performed.

Patient Data

Age: 70 years
Gender: Male

A triphasic liver scan was performed which demonstrates a protruding mass in IV and V segments of the liver with a possible infiltration of the gallbladder. In the arterial and portal venous phase, the lesion mimics a cavernous hemangioma. Ring enhancement is showed during the delayed phase consistent with hepatocellular carcinoma. The liver otherwise is unremarkable. No features of cirrhosis or portal hypertension are noted.

Case Discussion

Histological diagnosis of hepatocellular carcinoma (HCC) was confirmed. This is an unusual case of HCC that mimics a cavernous hemangioma. The most important image feature which helps to make the correct diagnosis is the rim enhancement persistent in the delayed phase.

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