Case 87:   Hepatocellular Carcinoma (HCC)

Diagnostic Category:

Clinical Presentation:

21 year old woman presents with abdominal pain.

CT: Fibrolamellar type, without central scar

Imaging Findings:

Multiphase CT in this patient with a non-cirrhotic liver reveals a well defined, hypervascular, surgical pathology proven fibrolamellar carcinoma, which demonstrates wash out in the portal venous phase.  Note that there is no central scar, which is atypical for fibrolamellar HCC, but not uncommon. Fibrolamellar hepatocellular carcinomas occur typically in young patients with no cirrhosis. Mosaic architecture (compartments of variable enhancement in random, rather than concentric distribution), is characteristic for HCC however.