Presentation
Known patient for chronic hepatitis B with a history of splenectomy following RTA 35 years ago. Presented with elevated alpha-fetoprotein.
Patient Data
Dysmorphic liver with hypertrophy of the lateral segments of the left lobe (segments 2 and 3) and caudate lobe with concomitant atrophy of the posterior segments (5 and 6) of the right lobe.
Well-defined hypodense ovoid mass of the right lobe of the liver centered on the segments (5, 6, 8).
The postcontrast demonstrates a vivid enhancement on the arterial phase, washout on the portal phase, and peripheral rim enhancement on the delayed phase (capsule).
Calcified hydatid cyst of the segment 8 (known).
Spleen not seen (history of splenectomy).
Simple left renal cysts.
Degenerative spine with osteoporotic compression fractures.
Case Discussion
The CT features are most consistent with hepatocellular carcinoma (HCC) in a patient known for chronic hepatitis B with elevated alpha-fetoprotein.
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