PMC9975153_01
Contrast-enhanced computed tomography (CT) findings on admission. Contrast-enhanced CT of the liver showed a mass in the S4 segment of the liver that darkened in the arterial phase and washed out in the delayed phase. The liver margins were unevenly distributed.
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The mass enhanced in the arterial phase and washed out in the portal venous and delayed phase ( Figure 1 ).
Ethoxybenzyl diethylenetriamine pentaacetic acid (EOB)-enhanced magnetic resonance imaging (MRI) findings. EOB-MRI of the liver revealed liver tumors with dark staining in the early phase (20 s), washout in the delayed phase (180 s), and decreased EOB uptake in the hepatocellular phase (20 min).
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Ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI showed a single mass in the liver with early uptake in the arterial phase, washout patterns at the equilibrium phase and lower signal intensity in the hepatobiliary phase, which strongly suggested HCC ( Figure 2 ).
Pathological findings of the patient's liver resection specimen. Surgical specimens and the pathological findings. (A) Cut specimen, (B1-D) show magnified images of the black circles. (B1, B2) Liver histological findings of hematoxylin-eosin (H.E) staining and Elastica-Masson (E.M) staining, x40, respectively. Liver fibrosis was observed, indicating F4 cirrhosis. The left half of the specimen is the cirrhotic area and the right half is the hepatocellular carcinoma area. Hepatocellular carcinoma growing in a macrotrabecular pattern or compact pattern. (C) Liver histological findings of E.M staining, x100. Hepatocytes show partial fatty degeneration, and the hepatic lobular structure has disappeared, revealing a fibrous septum. (D) Background liver showing fatty degeneration and ballooning of hepatocytes (H&E staining, 400x). (E) Histological findings of hepatocellular carcinoma. The main component is poorly differentiated hepatocellular carcinoma. Tumor cells proliferate in a macrotrabecular pattern and show pleomorphism, such as multinucleation and unequal size (H&E staining, 400x).
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Histopathological images of the specimens are shown in  Figure 3 .