Case 236:   Hepatocellular Carcinoma (HCC)

Diagnostic Category:

Clinical Presentation:

67 year old man with chronic hepatitis C infection. Screening ultrasound revealed a lesion in the right hepatic lobe. The lesion demonstrated mild increase in size over one year.

MR: Right hepatic vein invasion

Imaging Findings:

MR performed a few months after Y90 radioembolization of the lateral HCC in segment 8 (T1 hyperintense, T2 hypointense) shows new multinodular HCC (T1 hypointense, T2 hyperintense) in the right lobe with invasion of the right hepatic vein. Classic signs of tumor thrombus are shown in this case and include augmentation of the invaded vessel due to tumor expansion and enhancement of the tumor thrombus (portal venous phase) with washout on equilibrium phase. Also note thin transient hyperenhancement surrounding the mass and the invaded right hepatic vein.

Patient has accessory right hepatic vein more posteriorly.