PMC7545472_01
CT liver mass protocol with IV contrast showing evidence of cirrhosis with features of portal hypertension, an ill-defined infiltrative mass in left hepatic lobe suggestive of infiltrative HCC, hypoattenuating lesions in the right hepatic lobe, and periportal lymphadenopathy.
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Findings were highly suspicious for metastatic hepatocellular carcinoma (Figure 1).
Cross-sectional and sagittal images of CT head (with and without contrast) demonstrating a 3.1 cm x 3 cm x 3 cm enhancing soft tissue mass eroding through the frontal calvarium and extending into the anterior soft tissues of the scalp in the epidural space overlying the left frontal lobe.
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CT head revealed a 3.1 cm mass eroding through the frontal calvarium (Figure 2).
H&E 10x section shows well to moderately differentiated HCC with trabecular pattern. The inset (H&E 20x) shows large pleomorphic nuclei with nucleoli (histopathology of forehead lesion).
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Morphologically, these tumor cells resemble hepatocytic cells with slight atypia (Figures 3 and 4).
H&E 10x showing the forehead skin fragment as a contaminant on the right and the tumor on the left (histopathology of forehead lesion).
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Morphologically, these tumor cells resemble hepatocytic cells with slight atypia (Figures 3 and 4).
Hep Par-1 stain positive (histopathology and immunostaining of forehead lesion).
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Par-1 staining confirmed the lineage of these cells to be hepatocellular in origin (Figure 5). Polyclonal CEA staining (Figure 6) demonstrated a diffuse canalicular pattern, highly suggestive of HCC, rather than cytoplasmic staining as seen in cholangiocarcinoma and many other cancers.
Positive polyclonal CEA staining, diffuse canalicular pattern (histopathology and immunostaining of forehead lesion).
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fig6
Par-1 staining confirmed the lineage of these cells to be hepatocellular in origin (Figure 5). Polyclonal CEA staining (Figure 6) demonstrated a diffuse canalicular pattern, highly suggestive of HCC, rather than cytoplasmic staining as seen in cholangiocarcinoma and many other cancers.