An Uncommon Presentation of Hepatocellular Carcinoma

Abstract

Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer, with an important characteristic being the development on a background of cirrhosis. HCC in non-cirrhotic liver is rare. We report a case of an HCC on a non-cirrhotic liver in a 66-year-old patient who was admitted with a 3 months history of right hypochondriac pain and weight loss. He had a medical history of hypertension, type 2 diabetes, obesity, and no alcohol abuse. Abdominal computed tomography (CT) and hepatic magnetic resonance imaging (MRI) showed a 115x100x110mm mass in the segment V and VIII, hypodense with heterogeneous and early arterial enhancement, and clearing in portal and late phase. He underwent a liver biopsy that confirmed an HCC without underlying cirrhosis. Surgical treatment was not an option since our patient presented multiple risk factors of recurrence. The patient underwent two sessions of transarterial chemoembolization (TACE) but the follow-up showed signs of progression.