Hepatocellular carcinoma - cirrhotomimetic-type

Case contributed by Dr Amr Farouk

Presentation

Known liver cirrhosis presenting with systemic symptoms and mild jaundice with labs showing elevated bilirubin, decreased albumin levels and elevated alpha fetoprotein (1480 ng/mL).

Patient Data

Age: 70 years
Gender: Male

Cirrhotic liver with its parenchyma studded by multiple innumerable scattered focal lesions and nodules are seen varying in size from 1-2 mm to 3.2 cm in size with the largest in hepatic segment VI. They show intense enhancement at the arterial/portal phases with washout of contrast in the delayed phase. 3 x 2.4 cm pathologically-enlarged lymph node is seen inferoposterior to the pancreatic head showing a similar enhancement pattern to the hepatic lesions measuring .

Marked ascites.

Horseshoe kidneys showing no back pressure changes or masses.

Case Discussion

Multiple bilobar hepatic focal lesions and nodules with enhancement pattern pathognomonic of diffuse cirrhotomimetic-type HCC. This was supported by the marked elevated levels of alpha fetoprotein.

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Case information

rID: 63839
Published: 20th Oct 2018
Last edited: 22nd Oct 2018
Tag: hcc
Inclusion in quiz mode: Included
Institution: National cancer institute, Cairo, Egypt

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