Diffuse hepatocellular cancer with malignant portal vein thrombosis

Case contributed by Dr Ahmed Abdrabou

Presentation

Known patient with HCV and liver cirrhosis developed deteriorated liver function tests

Patient Data

Age: 70 years
Gender: Male

Typical cirrhotic changes are evident by enlarged left lobe, irregular nodular outer surface and widened fissures. There is malignant infiltration of the left hepatic lobe that enhances in the arterial phase and displays wash out on portovenous phase. Furthermore, there is malignant thrombus in the left branch of portal vein that follows the same enhancing criteria. GB stones, splenomegaly and left renal stone are other findings.

The white arrow refers to the thrombus tail.

Case Discussion

Malignant portal vein thrombus shows enhancing criteria as same as hepatocellular carcinoma on triphasic CT scan.

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