Multifocal hepatocellular carcinoma

Case contributed by Tariq Walizai


Right upper abdominal discomfort.

Patient Data

Age: 75 years
Gender: Male

The liver is mildly enlarged in size in its normal position and is showing multiple, variable-size, definable lesions (showing centrally non-enhancing parts that are most likely due to necrosis) in both lobes, with the largest one measuring about 8.6 x 10.3 cm in segment VIII. These lesions show arterial enhancement with washout in venous and delayed phases as compared to the adjacent hepatic parenchyma with differential multi-focal hepatocellular carcinoma. The hepatic and portal veins are patent. The intrahepatic and extrahepatic bile ducts are unremarkable. The gall bladder appears unremarkable.

The rest of the visualized organs appear within normal limits.

Case Discussion

Current CT features are concerning for most likely multi-focal hepatocellular carcinoma with hepatomegaly.

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