Case 210:   Hepatocellular Carcinoma (HCC)

Diagnostic Category:

Clinical Presentation:

62 year old woman, with chronic hepatitis C infection, found to have a hepatic mass on screening ultrasound (not shown)

CT: Pseudocapsule and vascular invasion

Imaging Findings:

Triphasic CT demonstrates HCC with pseudo capsule. The mass demonstrates intense arterial enhancement, except for a small posterior component, with wash out in the portal venous and equilibrium phases.

On the coronal reformatted images, there is associated malignant vascular invasion of the posterior branch of the right portal vein.  There is also a peripheral wedge shaped area of low attenuation extending to the capsular surface in a geographic/segmental distribution, representing an hepatic infarct.

Note on coronal reformatted image # 3 at equilibrium, there is progressive peripheral / peritumoral enhancement giving a "pseudocapsule" appearance, which is characteristic for HCC.