Hepatocellular carcinoma with peritoneal metastases
Known hepatitis C virus infection and liver cirrhosis. New generalised abdominal distension.
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Hepatic cirrhotic changes with right lobe focal lesion showing enhancement in arterial phase and rapid washout in portal venous and delayed phases. There is associated marked ascites and extensive peritoneal nodular thickening and masses, being larger and confluent in the right subphrenic region and right paracolic gutter.
Alpha feto-protein was elevated and biopsy from one of the peritoneal masses confirmed hepatocellular carcinoma. Peritoneal seeding with HCC is estimated to be found in 9% of cases in pathological specimens.