Atypical hepatocellular carcinoma in misdiagnosed cases of liver tumor

【Clinical history】

The patient, a 37-year-old male, was admitted to the hospital for 1 month due to the discovery of a hepatic space-occupying lesion

【Image picture】

CT image

【Video performance】

The cystic low-density foci with a size of about 45mm×40mm in the right posterior lobe of the liver, smooth edges, uneven density in the capsule, CT value of 13-33hu, enhanced scanning arterial phase showed linear vascular-like enhancement in the capsule, and the wall of the capsule was in various The phase showed continuous intensification (Figures 1-4)

There is a high possibility of cystic space-occupying lesions and cystadenomas in the right lobe of the liver

【Diagnosis points】

The CT manifestation of the liver cancer in this case was cystic, and there was no typical imaging manifestations of common liver cancer.

【discuss】

When necrotic cystic degeneration occurs in the center of hepatocellular carcinoma, it can appear as a cystic tumor.

The experience and lesson of this case is that a cystic tumor on liver CT may be pathologically solid even if the edges are smoothed.

【Comments】

Bile duct cystadenomas are rare intrahepatic cystic tumors, accounting for 5% of all hepatic cystic lesions.

On CT, the lesions are mainly manifested as low-density, cystic masses in the liver or hepatic hilum with clear and smooth borders, with a maximum diameter of 1.

Atypical hepatocellular carcinoma does not have the performance of "fast in and fast out", and the specific manifestations are different and have no uniform characteristics