Atypical Clinical and Imaging Presentation of a Large, Well-Differentiated Hepatocellular Carcinoma (HCC)

Author(s): Jardon, Meghan; Geng, Yipeng; Naini, Bita V; Sai, Victor | Abstract: [Original]Hepatocellular carcinoma (HCC) is the most common primary neoplasm of the liver, which arises from the parenchymal cells of the liver.1 Hepatocellular carcinoma usually develops in the setting of chronic background liver disease, such as cirrhosis or chronic hepatitis B or C infection. The diagnosis of HCC relies heavily on diagnostic imaging, and the high sensitivity and specificity of the Liver Imaging Reporting and Data System (LI-RADS) classification system allows for clinical decisions to be made based on imaging appearance alone.2 However, imaging classification systems such as LI-RADS rely on lesions following the multistep progression from dysplastic nodule to large, de-differentiated HCC in a step-wise fashion.3 In this case report, we will discuss an atypical case of a large, well-differentiated hepatocellular carcinoma with atypical imaging features, which presented in an asymptomatic young patient with no known liver disease.n[Updated]Hepatocellular carcinoma (HCC) is the most common primary neoplasm of the liver, and classically presents in the setting of background liver disease. In this case report, we present an atypical case of well-differentiated HCC which was detected in an asymptomatic 43-year-old man with no known underlying liver disease. We review the imaging features of this mass, which did not follow typical enhancement characteristics defined by the Liver Imaging Reporting and Data System (LI-RADS) classification criteria. The diagnosis was ultimately confirmed by surgical resection and pathologic analysis.