PMC7566196_01
Abdominal ultrasound showing a large lesion in the liver.
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An abdominal x-ray reveled a normal distribution of bowel gas, whereas an abdominal ultrasound reveled a large lesion in the liver (Fig. 1).
A computed tomography scan of the abdomen (coronal view) showing a large hypervascular liver lesion measuring approximately 14 x 10 x 15 cm.
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A computed tomography (CT) scan of the abdomen revealed a large hypervascular liver lesion measuring 14 x 10 x 15 cm occupying segments IV and VIII and part of V (Fig. 2, Fig. 3).
A positron emission tomography scan showed a large, globular, moderately hypermetabolic mass involving the central hepatic region sparing small portions of the right and left lobes that measured approximately 14.7 x 15.1 x 10.2 cm.
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The mass spared small portions of the right and left lobes superiorly and both liver lobes (Fig. 4).
A post-transarterial chemoembolization computed tomography scan of the abdomen (axial view) showing 40% necrosis of the mass.
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Four weeks after the procedure, a repeat abdominal CT scan showed stability of the large hypervascular liver lesion, with 40% necrosis of the mass (Fig. 5).
Intraoperative finding of a large, encapsulated mass occupying most of the central hepatic region.
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After complete removal of the tumor and the gall bladder, the methylene blue test was performed, and all leaking areas were sutured except the left lateral segment of the biliary drainage was reconstructed by hepatico-jejunostomy using a Roux-en-Y loop (Fig. 6).
A post-operative computed tomography scan of the abdomen (axial view) showing a surgical bed fluid collection measuring about 2.6 x 4.3 x 7.2 cm.
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A repeat abdominal CT scan performed after one month showed a stable surgical bed fluid collection measuring 7.2 x 1.4 x 2 cm (Fig. 7).