PMC3891166_01
Computed tomography showing a huge hepatic mass on arterial phase.
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F1
Abdominal enhanced computerized tomography (CT) scanning also revealed the same findings with right portal vein invasion (Figure 1).
(A) Initial chest X-ray showing no abnormalities. (B) Chest X-ray showing chest wall metastasis with invading adjacent ribs after 3 months. (C) Chest X-ray showing growing chest wall mass compared to previous images.
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F2
A chest X-ray showed a lesion which was invading the rib on the left upper lung (Figure 2). The mass size slowly increased up to 10x10 cm in diameter during the follow-up period (Figure 2).
(A) Computed tomography showing a metastatic mass invading the left sacrum. (B) Computed tomography showing decreased hepatic mass compared to initial scan.
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F3
HCC had decreased in size (about 4x3 cm) (Figure 3). His serum AFP was above 500 ng/mL.
Microscopic findings of clear cell hepatocellular carcinoma. Biopsy specimen from left anterior chest wall revealed eccentric nucleoli with vacuolated foamy-to-clear cytoplasm that did not stain with hematoxylin and eosin (x100)
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F4
Microscopic examination showed necrosis and eccentric nucleoli with vacuolated foamy-to-clear cytoplasm that did not stain with hematoxylin and eosin (Figure 4).
(A) Computed tomography showing a thickened left anterior chest wall but no mass lesion. (B) Computed tomography showing a further decreased hepatic mass lesion compared to previous images.
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F5
A CT scan revealed the same findings, and on the scanned upper-abdominal imaging, a further decrease in the primary lesion (about 3x2 cm) was noted (Figure 5).
Schematic presentation on the course of serum AFP level, liver mass size, chest wall lesion, and sacral lesion during follow-up.
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F6
Additionally, his serum AFP has decreased to 8.0 ng/mL (Figure 6).