Abdominal pain and jaundice in patient with known hepatitis C.
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Quad phase liver CT:
- noncontrast phase:
- cirrhotic liver
- hypodense right liver lobe mass
- arterial phase:
- large, well-defined right lobe mass with heterogenous hyperenhancement and areas of necrosis
- venous phase:
- enlarged IVC with hypodense filling defect of its intra hepatic as well as supra hepatic portions keeping with IVC thrombosis
- right branch of PV is dilated and completely filled with hypodense thrombus (enhancing, tumor thrombus)
- patent lumen of left branch and main trunk portal vein as well as SMV
- recanalized paraumbilical vein with portosystemic collaterals
- delayed phase shows relative hypoenhancement of the mass (wash out)
Mild abdominal ascites is noted.
65 year old patient, who was known to have hepatitis C virus, presented with abdominal pain and jaundice. Routine ultrasound detected a right hepatic lobe mass with thrombosed right portal vein branch. Laboratory findings of the patient included high alpha fetoprotein levels, in keeping with hepatocellular carcinoma.