Hepatocellular carcinoma

Case contributed by Dr Heba Mohamed

Presentation

Abdominal pain and jaundice in patient with known hepatitis C.

Patient Data

Age: 65 years old
Gender: Male
CT

Quad phase liver CT: 

  • noncontrast phase:
    • cirrhotic liver
    • splenomegaly
    • hypodense right liver lobe mass
  • arterial phase:
    • large, well-defined right lobe mass with heterogenous hyperenhancement and areas of necrosis
  • venous phase:
    • enlarged IVC with hypodense filling defect of its intra hepatic as well as supra hepatic portions keeping with IVC thrombosis
    • right branch of PV is dilated and completely filled with hypodense thrombus (enhancing, tumour thrombus)
    • patent lumen of left branch and main trunk portal vein as well as SMV
    • recanalised paraumbilical vein with portosystemic collaterals
  • delayed phase shows relative hypoenhancement of the mass (wash out)

Mild abdominal ascites is noted.

Case Discussion

65 year old patient, who was known to have hepatitis C virus, presented with abdominal pain and jaundice. Routine ultrasound detected a right hepatic lobe mass with thrombosed right portal vein branch. Laboratory findings of the patient included high alpha fetoprotein levels, in keeping with hepatocellular carcinoma.

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Case information

rID: 47965
Case created: 11th Sep 2016
Last edited: 7th Dec 2016
Inclusion in quiz mode: Included

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