PMC5836184_01
Noncontrast CT revealed mild liver enlargement, and 2-8 cm round-shaped lesions with regular contour and central hypodensity, disseminated throughout the liver, are observed. This is suggestive of intrahepatic metastases or multifocal HCC.
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F1
Abdominal computed tomographic (CT) scan showed mild hepatomegaly, perihepatic and flank fluid, and multiple hypodense liver lesions suggestive of intrahepatic metastases or multifocal HCC (Fig. 1).
Surgical aspect of one of the two actively bleeding liver tumors.
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F2
At emergency laparotomy, 2,800 mL of blood in the abdominal cavity were discovered; two actively bleeding liver tumors in segments III and VI, and multiple small nonbleeding tumors were observed (Fig. 2).
a Histologic examination showed acidophilic and polygonal neoplastic cells, with a solid pattern and bile pigment formation in an intracytoplasmic cumulus. Histologic elements are suggestive of HCC. Hematoxylin and eosin stain, x40. b Immunohistochemical analysis revealed intracytoplasmic positive reactivity for alpha-fetoprotein in neoplastic liver cells. Immunoperoxidase stain, x10.
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F3
Histopathologic analysis reported HCC and absence of cirrhotic changes (Fig. 3).