case_images: PMC11324258_01
case_images: CT abdomen and pelvis with contrast revealed a noncirrhotic liver morphology with a large right hepatic lobe centrally necrotic mass in the inferior aspect of segments 5/6 measuring 7.3 x 8.4 x 8.2 cm with adjacent infiltrative component extending superiorly in segment 5 and into several right anterior portal vein branches.
case_images: cro-2024-0017-0001-540260_F01.jpg
case_images: PMC11324258_01_cro-2024-0017-0001-540260_F01.jpg
case_images: F1
case_images: A CT abdomen and pelvis with contrast revealed a noncirrhotic liver morphology with a large right hepatic lobe centrally necrotic mass in the inferior aspect of segments 5/6 measuring 7.3 x 8.4 x 8.2 cm with adjacent infiltrative component extending superiorly in segment 5 and into several right anterior portal vein branches concerning for malignancy (Fig. 1).
case_images: An 8.8-cm well-circumscribed mass is seen arising from the inferior right hepatic lobe. This mass demonstrates heterogeneous arterial enhancement, washout, and pseudocapsule with central necrosis (a). An adjacent 4.9-cm lesion is seen within hepatic segment V with similar imaging characteristics (b). There is tumor invasion into the adjacent hepatic segment V portal vein, extending into the anterior right portal vein and segment IV portal vein branches (c).
case_images: cro-2024-0017-0001-540260_F02.jpg
case_images: PMC11324258_01_cro-2024-0017-0001-540260_F02.jpg
case_images: F2
case_images: MR abdomen without and with IV contrast showed two large lesions (8.8 cm and 4.9 cm) within the right hepatic lobe suspicious for multifocal HCC, with tumor invasion of the right portal vein branches (Fig. 2).
case_images: Interval development of fluid collection within the dominant mass in the inferior aspect of the right hepatic lobe (biopsy-proven HCC) with associated rupture of the liver capsule. Inflammation and small amount of ill-defined fluid at the site of capsular rupture.
case_images: cro-2024-0017-0001-540260_F03.jpg
case_images: PMC11324258_01_cro-2024-0017-0001-540260_F03.jpg
case_images: F3
case_images: ALT (shown in Table 1). A repeat CT of the abdomen and pelvis with IV contrast revealed interval development of fluid collection (6.6 x 4.3 cm) within dominant mass in the inferior aspect of the right hepatic lobe (biopsied area) with associated rupture of the liver capsule (Fig. 3), additional enlarging hepatic masses from prior imaging, and irregular thickening of the gallbladder wall adjacent to liver masses concerning for tumor invasion.