Hepatocellular carcinoma

Case contributed by Dr Ayaz Hidayatov

Presentation

A patient with a known history of chronic hepatitis C infection presented with elevated alpha-fetoprotein (AFP) levels.

Patient Data

Age: 55-60 years
Gender: Male
CT

Pre-contrast, arterial, and portal venous phase CT images demonstrate a 29 x 26 mm well-defined lesion at segment VII of the liver. The lesion shows arterial hyperenhancement and washout in the portal venous phase. Findings are most compatible with hepatocellular carcinoma.

The liver is atrophic and has a nodular surface, in keeping with cirrhosis and there is mild splenomegaly and distal paraesophageal varices due to portal hypertension.

The right branch of the hepatic artery arises early from the right edge of the celiac trunk and is best seen on coronal MIP and 3D volume imaging.

Case Discussion

The case illustrates typical CT findings of hepatocellular carcinoma.

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