Early hepatocellular carcinoma developed within dysplastic nodule as nodule-within-nodule appearance: Case report with literature review

Farid Aassouani, MD; Fatima-Zahra Lkharrat, MD; Yahya Charifi, MD; Aicha Attar, MD; Maria Lahlali, MD; Nizar El Bouardi, PhD; Hakima Abid, PhD; Meryem Haloua, PhD; Badreeddine Alami, PhD; Meriem Boubbou, PhD; Mustapha Maaroufi, PhD; Moulay Youssef Alaoui Lamrani, PhD

Radiology Case Reports (Nov 2022)

Early hepatocellular carcinoma developed within dysplastic nodule as nodule-within-nodule appearance: Case report with literature review

Farid Aassouani, MD,
Fatima-Zahra Lkharrat, MD,
Yahya Charifi, MD,
Aicha Attar, MD,
Maria Lahlali, MD,
Nizar El Bouardi, PhD,
Hakima Abid, PhD,
Meryem Haloua, PhD,
Badreeddine Alami, PhD,
Meriem Boubbou, PhD,
Mustapha Maaroufi, PhD,
Moulay Youssef Alaoui Lamrani, PhD

Affiliations

Farid Aassouani, MD: Department of Radiology and Interventional Imaging, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco; Department of Radiology and Clinical Imaging, Faculty of Medicine and Pharmacy, University of Fez, BP. 1893; Km 2.200, Sidi Hrazem Rd, Fez 30000, Morocco; Corresponding author.
Fatima-Zahra Lkharrat, MD: Department of Radiology and Interventional Imaging, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Yahya Charifi, MD: Department of Radiology and Interventional Imaging, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Aicha Attar, MD: Department of Gastroenterology CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Maria Lahlali, MD: Department of Gastroenterology CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Nizar El Bouardi, PhD: Department of Radiology and Interventional Imaging, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Hakima Abid, PhD: Department of Gastroenterology CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Meryem Haloua, PhD: Department of Radiology and Interventional Imaging, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Badreeddine Alami, PhD: Department of Radiology and Interventional Imaging, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Meriem Boubbou, PhD: Department of Radiology and Interventional Imaging, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Mustapha Maaroufi, PhD: Department of Radiology and Interventional Imaging, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco
Moulay Youssef Alaoui Lamrani, PhD: Department of Radiology and Interventional Imaging, CHU Hassan II, FEZ, Sidi Mohammed Ben Abdellah University, Fez, Morocco

Journal volume & issue: Vol. 17, no. 11
pp. 4087 – 4090

Abstract

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Close follow-up of patients with liver cirrhosis has led to increased detection of hepatocellular carcinoma (HCC) at an early stage, especially with magnetic resonance imaging (MRI) innovations. We report the case of a 70-year-old man, with a recent history of liver cirrhosis due to chronic hepatitis C virus (HCV) complicated by hepatocellular carcinoma (HCC), and for whom trans-arterial chemoembolization (TACE) was planned, as the patient was assigned Child B7 at admission. Angiography performed during the first TACE cycle shows not only the “tumor blush” corresponding to previously detected HCC but also an additional small foci of HCC uptake seen within a large dysplastic nodule giving the appearance of “nodule-within-nodule.” Early detection of hepatocellular carcinoma improves prognosis. Hence, it is essential to be aware of all early aspects of HCC, including the nodule-within-nodule appearance on cross-sectional imaging, and also in angiography, as in this case.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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