Hepatocellular carcinoma

Case contributed by Dr Ali Abougazia

Presentation

Known hepatitis C patient. Recent progressive abdominal pain.

Patient Data

Age: 64
Gender: Male
CT

Enlarged liver with cirrhotic features in the form of coarse parenchyma, irregular borders and enlarged left and caudate lobes. A large infiltrative and ill-defined right hepatic lobe focal lesion measuring 18.3 X 15.6 X 11.3 cm in orthogonal dimensions is seen infiltrating segments VI and VII, being heterogenous in the precontrast phase with dense heterogenous arterial enhancement and rapid washout in the subsequent portal and venous phases as well as delayed capsule enhancement. No biliary radicles dilatation.

Porta hepatis enlarged lymph node is noted measuring 1.6 cm in short axis. Small shotty para-aortic lymph nodes are seen as well.

Patent well-enhanced portal vein and its branches.

Mildly enlarged spleen. 

Normal CT appearance of the pancreas and both kidneys.

Vascular study shows marked atherosclerotic changes of the abdominal aorta.

No ascites. 

Case Discussion

Liver cirrhosis with right liver lobe infiltrative necrotic hypervascular lesion, diagnostic of hepatocellular carcinoma (HCC), with porta-hepatis and para-aortic lymphadenopathy. Splenomegaly.

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Case information

rID: 23633
Case created: 29th Jun 2013
Last edited: 6th Oct 2015
Inclusion in quiz mode: Included

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