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Hepatocellular carcinoma

Case contributed by Roberto Schubert
Diagnosis almost certain

Presentation

Liver cirrhosis with portal hypertension. Status post TIPS placement.

Patient Data

Age: 65 years
Gender: Male

This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

mri

Two nodular lesions are observed in liver segments VII and VIII. Both are invisible on T2. The larger one has a hypointense rim on T1. Both enhance during the arterial phase and wash out centrally on the more delayed images consistent with hepatocellular carcinoma in a patient with cirrhosis. There are also some periportal cysts. The dark ring with central enhancement on the T1-weighted images is the TIPS stent (red arrow on the annotated image).

mri

There are two nodular lesions (blue arrows on the annotated image). Both are invisible on T2. The larger one has a hypointense rim on T1. Both enhance during the arterial phase and wash out centrally on the more delayed images consistent with hepatocellular carcinoma in a patient with cirrhosis. There are also some periportal cysts. The dark ring with central enhancement on the T1-weighted images is the TIPS stent (red arrow on the annotated image).

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