Multicenteric hepatocellular carcinoma with arteriovenous shunt

Case contributed by Dr Ahmed Abdrabou

Presentation

Known patient with liver cirrhosis developed dyspnea and chest tightness

Patient Data

Age: 50 years
Gender: Male

Multiple hepatic focal lesions that display early arterial enhancement followed by rapid washout in portal venous phase. Early filling of the left hepatic vein which appears abnormally dilated suggest A-V fistulous communication. Transient hepatic attenuation difference is also noted at right and left lobes.

Diagnosis Multicentric hepatocellular carcinoma with A-V fistula

Case Discussion

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