Presentation
Abdominal pain and elevated liver enzymes.
Patient Data
Moderate abdominopelvic ascites is present.
The liver has irregular margin and nodular parenchyma in keeping with cirrhosis.
Large ill-defined hypervascular mass with delayed washout is present at right liver lobe. A few small hepatic masses with similar enhancement pattern are also scattered. Dilated collateral vessels are seen at peripancreatic regions.
The spleen is enlarged and its cephalocaudal height measured 195mm.
The liver shows marginal irregularity and heterogeneous internal signal intensity.
A large and ill defined mass is seen at superior aspect of right hepatic lobe, which is low signal on T1WI, high signal on T2WI. After contrast injection, it shows hyperenhancement on arterial phase with rapid washout. Splenomegaly is evident.
Case Discussion
Cirrhosis with portal hypertension, splenomegaly & ascites.
Hepatic hypervascular masses inferring hepatocellular carcinoma.