Cirrhosis and hepatocellular carcinoma in the setting of hemochromatosis

Case contributed by Dr Andrei Dumitrescu

Presentation

Bleeding esophageal varices.

Patient Data

Age: 70 years
Gender: Male

Cirrhotic appearance of the liver with several masses and nodules in the right lobe suggesting multifocal HCC. Thrombosis of the portal vein, also involving intrahepatic branches in the right lobe. Signs of chronic portal hypertension: gastric and esophageal varices, ascites. Atrophic pancreas.

Cirrthotic appearance of the liver with diffuse signal loss due to iron deposition. Several masses and nodules in the right hepatic lobe suggesting multifocal HCC. Thrombosis of the portal vein, also involving intrahepatic branches in the right lobe. Signs of chronic portal hypertension: gastric and esophageal varices, ascites. Atrophic pancreas.

Case Discussion

This elderly patient presented with upper GI bleeding from ruptured esophageal varices. Blank medical history, "never went to the doctor". Imaging shows hemochromatosis and cirrhosis of the liver, as well as several liver masses and nodules. There is also portal vein thrombosis with extensive involvement of intrahepatic branches in the right lobe. Biopsy of the largest mass revealed hepatocellular carcinoma (HCC). There is extensive literature linking hemochromatosis to liver cirrhosis and also HCC.

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Case information

rID: 75394
Published: 1st Apr 2020
Last edited: 1st Apr 2020
Inclusion in quiz mode: Included
Institution: xraydoc.eu