Hepatocellular carcinoma

Case contributed by Dr Suraindra Rajadurai

Presentation

Presented with jaundice and abdominal pain with a background of known Hep B cirrhosis.

Patient Data

Age: 50 years
Gender: Male
CT

Large heterogeneous arterial enhancing mass in the left hepatic lobe with portal venous phase washout. The mass is diffusely infiltrating the liver and there is evidence of both portal vein and IVC invasion by enhancing tumor thrombus. Tumor thrombus extends into the right atrium.

Background features of cirrhosis and portal hypertension, including ascites, porto-systemic varices, and splenomegaly. Cavernous transformation of the main portal vein likely reflects an element of chronic thrombus/occlusion in addition to the more recent tumor in vein. 

Case Discussion

This is a large, aggressive, diffusely-infiltrating hepatocellular carcinoma (HCC). It not only demonstrates portal vein invasion which is a common feature of HCC, but also IVC and right atrial invasion, which is not commonly seen. 

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Case information

rID: 62295
Published: 21st Oct 2020
Last edited: 21st Oct 2020
Tag: liver, hcc
Inclusion in quiz mode: Included
Institution: Austin Health