PMC9468985_01
Timeline of the events. US, ultrasound scan; CT, computed tomography; FNA, fine needle aspiration; CIS-GEM, cisplatin-gemcitabine; MRI, magnetic resonance imaging; MDT, multi-disciplinary team; RALPPS, radiofrequency-assisted associating liver partition and portal vein ligation for staged hepatectomy.
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A 36-year-old man presented in July 2018 complaining of a burning sensation in his chest exacerbated by exercise (Figure 1).
MRI scan of the liver after presentation. MRI, magnetic resonance imaging.
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A magnetic resonance imaging (MRI) with contrast (Figure 2) was scheduled and revealed a 33-mm mass in the left lobe and multiple focal lesions (maximum 15 mm) throughout the right lobe. All lesions demonstrated low signal on
CT scan of the liver after stage 1 of RALPPS showing FLR. CT, computed tomography; RALPPS, radiofrequency-assisted associating liver partition and portal vein ligation for staged hepatectomy; FLR, future liver remnant.
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Future liver remnant (FLR) volume increased from 386 to 436 cm3 (13% increase), and as such was deemed satisfactory for progression to stage 2 (Figures 3,4).
CT scan of the liver after stage 2 of RALPPS. CT, computed tomography; RALPPS, radiofrequency-assisted associating liver partition and portal vein ligation for staged hepatectomy.
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Follow-up CT scan at 90 days showed good response to surgical treatment, with almost complete resolution of HEHE lesions and no evidence of distant disease (Figure 5).