Case 88:   Hepatocellular Carcinoma (HCC)

Diagnostic Category:

Clinical Presentation:

18 year old woman with right upper quadrant pain.

CT: Fibrolamellar type, typical, with central scar, no cental calcification

Imaging Findings:

Multiphase CT shows a large, well circumscribed hypervascular fibrolamellar type HCC, demonstrating washout on the equilibrium phase. Note the central irregular scar, which demonstrates typical delayed enhancement, which can be seen in up to 25% of fibrolamellar carcinoma. Also, note metastatic supradiaphragmatic lymphadenopathy (arrow), typical for a large malignancy located in the upper liver segments. Note there is no cirrhosis.  Biopsy and resection specimen confirmed the diagnosis of fibrolamellar carcinoma.