case_images: PMC10905057_01
case_images: PMC10905057_02
case_images: Diagnostic imaging of hepatocellular carcinoma: contrast-enhanced CT and bone scintigraphy findings. a-c) Contrast-enhanced computed tomography shows that there are multiple tumors (red arrows) of up to 65 mm diameter in both lobes of the liver, which is a typical finding of hepatocellular carcinoma, with tumor enhancement in the early phase and washout in the late phase. d) Bone scintigraphy shows metastatic lesions (red arrows) in the L3 vertebral body.
case_images: cureus-0016-00000053278-i01.jpg
case_images: PMC10905057_02_cureus-0016-00000053278-i01.jpg
case_images: FIG1
case_images: Contrast-enhanced computed tomography (CT) showed multiple tumors of up to 65 mm in diameter in both lobes of the liver, a typical finding of HCC, with tumor enhancement in the early phase and washout in the late phase (Figure 1a-1c). Bone scintigraphy revealed metastatic lesions in the L3 vertebral body (Figure 1d).
case_images: PMC10905057_03
case_images: Histopathological and immunohistochemical analysis of a liver tumor biopsy revealing hepatocellular carcinoma. a-b) A liver tumor biopsy was performed to confirm the diagnosis. Haematoxylin and eosin staining of the carcinomatous specimen shows well-differentiated hepatocellular carcinoma and that of noncancerous portions shows no fibrosis and/or inflammatory infiltration. c-d) Immunostaining for hepatitis B surface and hepatitis B core antibodies showed negative results.
case_images: cureus-0016-00000053278-i02.jpg
case_images: PMC10905057_03_cureus-0016-00000053278-i02.jpg
case_images: FIG2
case_images: The biopsy showed well-differentiated HCC tumor morphology, while immunostaining for HBsAb and HBcAb showed negative results (Figure 2).
case_images: PMC10905057_04
case_images: Juvenile hepatocellular carcinoma: treatment course and variations in tumor markers. AFP, alpha-fetoprotein; PIVKA-II, protein induced by vitamin K absence-II; Atezo, atezolizumab; BV, bevacizumab; CAB, cabozantinib; LEN, lenvatinib; SFN, sorafenib
case_images: cureus-0016-00000053278-i03.jpg
case_images: PMC10905057_04_cureus-0016-00000053278-i03.jpg
case_images: FIG3
case_images: Figure 3. Figure 4 shows a time series of CT images of the tumor in the left lobe of the liver. Unfortunately, the patient expired on October 20, 2021 (day 622) due to a ruptured HCC (Figure 3).
case_images: Sequential changes in liver tumor size in the left lobe following treatment with lenvatinib. Time series of tumor changes in the left lobe of the liver (red arrows). The initial treatment with lenvatinib had an inhibitory effect; thereafter, a gradual trend toward enlargement was observed.
case_images: cureus-0016-00000053278-i04.jpg
case_images: PMC10905057_04_cureus-0016-00000053278-i04.jpg
case_images: FIG4
case_images: Figure 3. Figure 4 shows a time series of CT images of the tumor in the left lobe of the liver.