Abstract

Hepatocellular carcinoma (HCC) typically shows hepatic arterial phase contrast-enhancement and wash out pattern at portal phase. Hepatic dysplastic nodules show diverse imaging characteristics but commonly show hypoattenuation pattern at CT-imaging. We report an 3 cm sized atypical hypovascular HCC which was thought to orginate from dysplastic nodule. Fifty senven year old female who had suffered from chronic hepatitis B had three separate hepatic nodules initially. One in seg 7 diagnosed as well-differentiated HCC, another in seg 5 as dysplastic nodule by US guided needle biopsy. Remaining 1.5 cm sized nodule in seg 4 which showed isoattenuation at arterial phase and hypoattenuation at portal phase. We avoid invasive treatment to seg 4 nodule due to vicinity of great vessel. We performed transarterial chemoembolization (TACE) and percutaneous ethanol injection to the seg 7 & seg 5 lesions and followed up with TACE. At 2 years later the nodule in seg 4 grew up to 3 cm sized mass with showed persistency no arterial phase enhancement and partially hypoattenuating-isoattenuating pattern at portal phase. The mass diagnosed as clear cell type HCC (Edmoson grade Ⅱ) by US guided biopsy.

• Keywords: HCC;Hypovascular HCC;Dysplastic nodule