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48-year-old male has a 10 cm palpable mass and pain in the R upper quadrant.
Abdominal CT scan: 14 x 12cm heterogenous mass within inferior R lobe of liver highly suspicious for primary hepatic malignancy. No intrahepatic biliary ductal dilatation. Portal, superior mesenteric, splenic veins all normal. No lymphadenopathy seen. Chest CT negative.
AFP 3.1(0 -8.0 ng/ml). Hepatitis B and C screens negative.
15 x 16 cm lobulated mass extends from the inferior R lobe of liver segment 5 and 6. The mass is fairly well circumscribed and contains a large, thin-walled dilated vein. No evidence of metastasis in abdomen.
Liver mass aspiration R lobe: mod diff hepatocellular carcinoma
Liver resection: hepatocellular carcinoma 14 x 10 x 12 cm, grade 1-2 w/focal 3 of 4. Tumor is largely encapsulated and has a pushing margin. Focal vascular invasion seen. Margins negative.
Partial R hepatic lobectomy and cholecystectomy.