Presentation
Elevated liver enzymes and alpha-fetoprotein.
Patient Data
Massive abdominopelvic ascites is present.
The liver is atrophic and has irregular margins inferring cirrhosis.
At least three hypervascular masses with delayed washout are noted in the liver, suggesting hepatocellular carcinoma.
Recanalization of the falciform ligament vascular structures and umbilical vein are seen, accompanied by some perigastric and distal paraesophageal collateral vessels consistent with portal hypertension.
The prostate gland is enlarged.
Degenerative changes such as osteophytosis are seen in the lumbar spine.
Scoliosis with leftward convexity is present in the lumbar spine.
Case Discussion
Cirrhosis with evidence of portal hypertension, ascites, and multifocal hypervascular masses compatible with hepatocellular carcinoma.
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