case_images: PMC9705775_01
case_images: (A) Transverse ultrasound (US) images of a large hypoechoic lesion with an irregular border and non-uniform internal echoes in the left lobe of the liver. Additionally (B) there is a filling defect approximately 1.7 cm in diameter within the trunk of the portal vein (arrow). (C) Axial and (D) coronal plain abdominal CT scans revealed a decompensated period of cirrhosis, a lobulated and inhomogeneous mass with a slightly lower density in the left lobe, measuring 13.5 cm x 6.8 cm, and the presence of ascites and bilateral pleural effusion (arrow).
case_images: fmed-09-1005680-g0001.jpg
case_images: PMC9705775_01_fmed-09-1005680-g0001.jpg
case_images: F1
case_images: Abdominal CT plain scans depicted a decompensated period of cirrhosis, a lobulated and inhomogeneous mass with a slightly lower density in the left lobe, measuring 13.5 cm x 6.8 cm, and the presence of ascites and bilateral pleural effusion (Figure 1).
case_images: (A) Axial T1-weighted magnetic resonance imaging (MRI) and (B) axial T2-weighted MRI scans showed a bulky multicystic hepatic mass with multiple septa (arrowheads) situated in the left hepatic external lobe, and (C) a diffusion-weighted MRI scan presented a restriction of diffusion. Axial contrast-enhanced T1-weighted MRI scans showed local enhancement in the lesion, and most of the lesion suggested the absence of being not significantly obviously enhanced in the arterial phase (D), and mild to moderate delayed enhancement was found in the perifocal and internal septum of the portal venous phase (E) and the delayed phase (F) (arrow) (G) Coronal contrast-enhanced presented with a filling defect in the trunk of the portal vein (arrow).
case_images: fmed-09-1005680-g0002.jpg
case_images: PMC9705775_01_fmed-09-1005680-g0002.jpg
case_images: F2
case_images: Moreover, a filling defect in the trunk of the portal vein was observed (Figure 2).
case_images: Unenhanced (A) and contrast-enhanced abdominal CT images were obtained 20 weeks after the initial presentation. The mass on the left liver lobe disappeared, and the portal vein-filling defect was markedly reduced after post-therapy imaging. (B) The axial arterial phase. (C) The axial portal venous phase, and (D) the delay phase. Note that the bilateral pleural effusion indicated significant absorption.
case_images: fmed-09-1005680-g0003.jpg
case_images: PMC9705775_01_fmed-09-1005680-g0003.jpg
case_images: F3
case_images: AFP had completely normalized upon review after stopping the medication for 20 weeks, and the imaging displayed that the mass on the left liver lobe had disappeared, the portal vein filling defect had markedly reduced, and ascites and bilateral pleural effusion reduced in the patient (Figure 3). At the 2-year follow-up, no evidence of recurrence was observed (Figure 4), and the patient had recovered well.
case_images: Following the initial presentation, enhanced CT was obtained 2 years later, which revealed that the mass on the left liver lobe and the portal vein-filling defect had disappeared. Note that the intraperitoneal effusion had been also absorbed (A-D).
case_images: fmed-09-1005680-g0004.jpg
case_images: PMC9705775_01_fmed-09-1005680-g0004.jpg
case_images: F4
case_images: AFP had completely normalized upon review after stopping the medication for 20 weeks, and the imaging displayed that the mass on the left liver lobe had disappeared, the portal vein filling defect had markedly reduced, and ascites and bilateral pleural effusion reduced in the patient (Figure 3). At the 2-year follow-up, no evidence of recurrence was observed (Figure 4), and the patient had recovered well.