Metastatic Liver Cancer Mimicking Hepatocellular Carcinoma in Alcoholic Cirrhosis

Kim, Hee Yeon; Kim, Chang Wook; Lee, Chang Don; Lee, Su Lim; Won, Yoo Dong; Kim, Ye Il

doi:2014.14.1.41

J Liver Cancer > Volume 14(1); 2014 > Article

Case Report

Journal of the Korean Liver Cancer Study Group 2014;14(1):41-45.
DOI: https://doi.org/10.17998/jlc.14.1.41 Published online March 31, 2014.

Metastatic Liver Cancer Mimicking Hepatocellular Carcinoma in Alcoholic Cirrhosis

Hee Yeon Kim¹, Chang Wook Kim¹, Chang Don Lee¹, Su Lim Lee², Yoo Dong Won², Ye Il Kim²

¹Departments of Internal Medicine The Catholic University of Korea College of Medicine, Seoul, Korea
²Departments of Radiology, The Catholic University of Korea College of Medicine, Seoul, Korea

Abstract

A 50-year-old male patient visited for further evaluation of arterial enhancing nodules in cirrhotic liver. Computed tomography (CT) scan revealed vaguely nodular, arterial phaseenhancing nodules at segment 8 of the liver with cirrhotic background. Magnetic resonance imaging (MRI) showed four small nodules with early work-up enhancement in arterial phase and rapid washout. Angiography showed hypervascular nodular stains. Hepatocellular carcinoma (HCC) was diagnosed according to the noninvasive diagnostic criteria for HCC. A positron emission tomography (PET) scan was done for staging work-up, and increased uptake was noted in rectum. Subsequently, sigmoidoscopy revealed an ulceroinfiltrative lesion encircling the lumen of the rectosigmoid junction. Laparoscopic low anterior resection with wedge resection of liver was done, suspecting concurrent primary tumors of the rectum and liver. Pathologic examination demonstrated moderately differentiated adenocarcinoma in both rectum and liver, suggesting metastatic rectal carcinoma. The present case indicates that metastatic carcinoma as well as HCC should be considered in the differential diagnosis of irregularly enhancing small nodules even in high-risk patient group for HCC.

Key Words: Carcinoma, Hepatocellular; Metastases, Neoplasm; Cirrhosis, Liver

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