Hepatocellular carcinoma - atypical with central scar

Case contributed by Dr Natalie Yang ◈

Diagnosis almost certain

Presentation

Cirrhotic patient on follow up imaging.

From the case: Hepatocellular carcinoma - atypical with central scar

MRI

MRI Liver

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Axial T1 in-phase

Selected MR images demonstrate heterogeneous enhancing lesion. Note that the peripheral components on the right side of the mass demonstrate more characteristic early arterial enhancement with washout, becoming hypointense c.f to the remainder of the liver. The central non-enhancing component remained non enhancing even in further delayed post contrast phases.

Rim enhancement, which is more obvious in delayed images.