Steatohepatitic hepatocellular carcinoma (SH-HCC)

Case contributed by Dr Jayanth Keshavamurthy


Treated type 1 A HCV undergoes screening ultrasound of the liver for HCC every 6 months.

Patient Data

Age: 65 years
Gender: Male

There is a new echogenic lesion in the liver concerning for a neoplasm, recommend multiphasic CT scan of the liver.

Mutliphasic CT showing a mass in segment 4a of the liver, not a characteristic hemangioma, recommend MRI.

Multiphasic MRI showing a new rim-enhancing lesion concerning for malignancy not necessarily HCC, biopsy recommended.

Thanks to Dr.Lakshmi Vemavarapu MD for the pathology description of the HCC.

Case Discussion

The patient was referred to a hepatologist and to a hepatic surgeon for further management.

SH-HCC is a frequent variant of HCC in NAFLD patients and HCV patients. As a radiologist you will see above fatty features in CT, MRI and on sonogram. So have a low threshold for biopsy and evaluation when in doubt.

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Case information

rID: 68460
Published: 1st Jun 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Augusta University

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