Case #4

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Expand Physical Exam


48-year-old male has a 10 cm palpable mass and pain in the R upper quadrant.

Expand X-Rays & Scans


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.

Expand Laboratory


AFP 3.1(0 -8.0 ng/ml). Hepatitis B and C screens negative.

Expand Operative Findings


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.

Expand Pathological Reports


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.

Expand Treatment


Partial R hepatic lobectomy and cholecystectomy.