Case 89:   Hepatocellular Carcinoma (HCC)

Diagnostic Category:

Clinical Presentation:

53 year old man presents with jaundice.

CT: Fibrotic HCC with portal venous tumor thrombus and bland thrombus

Imaging Findings:

Multiphase CT reveals HCC and both bland and tumor thrombus in the portal venous system. Enhancing thrombus in the right portal vein represents tumor thrombus. Non-enhancing thrombus within the anterior and posterior segmental branches represents bland thrombus. Reactive perfusion anomalies on arterial phase obscure the parenchymal portion of the HCC. Note delayed enhancement of large portions of the HCC on equilibrium phase, typical for fibrotic components. Mixed cholangio-hepatocellular carcinoma may have the same enhancement pattern.