Presentation
Recent abdominal pain
Patient Data
There is a 4.2 x 3.6 x 3.9 cm mass centered in segment IV. It is causing intrahepatic duct dilation of segment II, III, IV, with advanced atrophy of segment IV.
No other lesion is noticed.No extrahepatic dilation (CBD = 4 mm).
This tumor abuts the right hepatic vein for a significant length, and is close to but not involving the right bile ducts.
The left umbilcal portal vein, and the left hepatic is directly involved by tumor.
The transverse portion of the left portal vein is not involved.
The right hepatic artery is replaced.
The liver demonstrates a drop in signal on the out of phase T1 sequence in keeping with mild fatty infiltration.
There are several lobulated cystic lesions within the pancreas. The two prominent are at the head (2 cm) and body/tail (1.1 cm). They appear to communicate with the main pancreatic duct. No pancreatic duct dilation. No post contrast enhancement.
The adrenals, spleen and visualized kidneys are unremarkable.
There is 1.4 cm lymph node at the portal region. No other lymphadenopathy.
Conclusion
A 4.2 cm segment IV cholangiocarcinoma with early obstruction of the left lateral sector.
A considerable length of the middle hepatic vein borders the tumor. Metastatic portal lymphadenopathy.
A few small pancreatic IPMN, in the head and in the tail.
Unable to process the form. Check for errors and try again.