Multicentric HCC with portal vein thrombosis and arterioportal shunt

Case contributed by Dr Ahmed Abd Rabou

Presentation

Known case of liver cirrhosis developed progressive abdominal pain and distension

Patient Data

Age: 55 years old
Gender: Female

The liver is cirrhotic showing multiple variable size scattered focal lesions that display enhancement in arterial phase followed by washout in subsequent phases. There is enhancing tumoral thrombosis invading the right branch of PV and early enhancement of the left branch of PV denoting development of arterio-portal fistula.

Case Discussion

The typical enhancement criteria of hepatocellular carcinoma is enhancement in arterial phase followed by rapid washout in portovenous and delayed phases. This is owing to its tumoral angiogenesis. Two complications of HCC is seen in the current case including tumoral invasion of the portal vein and arterio-portal AV shunt. Biopsy from the hepatic lesion confirms hepatoma.

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Case information

rID: 27751
Case created: 18th Feb 2014
Last edited: 13th Mar 2016
Inclusion in quiz mode: Included

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