Hepatocellular carcinoma

Case contributed by Diana Karen Garza
Diagnosis certain


Stabbing pain in the right hypochondrium, accompanied by chills and sweating; has worsened recently.

Patient Data

Age: 20 years
Gender: Female

16 x 15 cm oval well-circumscribed mass of right hepatic lobe, with irregular borders with peripheral areas of greater enhancement, and subtle partial washout on late phase in right liver lobe. Secondary inferior displacement and axial rotation of right kidney. Perihepatic fatty striation.

Additionally, atelectasis is observed in the lung bases and traces of bilateral pleural effusion.


Pathology report (Spanish) Right hepatic lobe resection and liver tumor biopsy.


  • “Moderately differentiated hepatocarcinoma, with trabecular and solid patterns”.

  • Embolization changes (extensive ischemic necrosis).

  • Ruptured liver capsule and spread to perihepatic adipose tissue.

Initially, the suspected diagnosis was of a giant hemangioma. Embolization was performed prior to the surgical procedure. Right lobectomy with trans-surgical biopsy was performed with the histopathological result of moderately differentiated hepatocellular carcinoma with trabecular and solid patterns.

Case Discussion

Hepatocellular carcinoma (HCC) in young adults is commonly seen due to perinatal HBV infections or metabolic disorders.

Most hepatocellular carcinomas measure less than 2 cm. If they are larger than these, they tend to be more aggressive and with a greater risk of vascular inasion as well as metastasis.

The prognosis depends on the stage in which it is diagnosed, however, the patient who presents symptoms has a poor short-term prognosis with a survival rate of 10% at 5 years.

In the early stages of HCC, resection is the best choice of action. For advanced to moderate stages of HCC TACE may be more beneficial. A liver transplant can also be an effective treatment; however, more research on this treatment is needed.

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