case 390=pedunculated hcc, dr phan thanh hẢi

CASE 390: PEDUNCULATED HCC, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

MAN 56 YO REPORTED  HIS RUQ  SWOLLEN  SLOWLY FOR  6 MONTHS , NO DISTURB GI TRACK IN DIGESTION.ULTRASOUND ABDOMEN:US 1:ECHOGENEICITY OF LIVER  AND TUMOR  NEARBY  ARE DIFFERENT.

US 2:LONGITUDINAL SCAN,TUMOR AND LIVER BORDER ARE NOT CLEAR.

US 3: STRUCTURE OF THIS TUMOR IS SOLID, HYPOVASCULAR.

US 4: CROSS SECTION, TUMOR IS INTRA ABDOMEN, AT RIGHT  SITE OF AORTA.

MSCT WITH CE:

CT 1( 4 PICTURES): SAGITTAL VIEW, FRONTAL VIEW ,  CROSS-SECTION SHOWED VASCULAR SUPPLY OF THIS TUMOR IS FROM LIVER.

CT1:TUMOR IS  RELATED WITH  R/LIVER,   PEDUNCULATED, VASCULAR SUPPLY FROM LIVER.

CT2:MULTINODULAR, CONTRAST ENHANCE IS  IN BORDER OF TUMOR.

LAB BLOOD TESTS  =  HBV POSITIVE, AFP=651.8 ng/mL.

Operation  laparotomy  detected huge tumor connected with right liver border bysmall area.

Microscopic report  is  undiffentiated  HCC 

( P-HCC; PEDUNCULATED HCC or  HANGING HCC..)

SUMMARY=   PRE OP IS SUSPECTED HCC, BUT IT  HAD PEDUNCLE  COME FROM RIGHT LIVER. LAPAROTOMY REMOVED BIG TUMOR  FROM THE RIGHT  LIVER.

REFERENCE:PEDUNCULATED HCC