Atypical presentation of a locally advanced hepatocellular carcinoma: Extensive workup of an incidental finding on computed tomography performed for planning of transcatheter aortic valve implantation

Julia Lueg, MD; Fabian Knebel, MD; Ibrahim Awwad, MD; Markus H. Lerchbaumer, MD; Ute Fahlenkamp, MD; Alexander Lembcke, MD; Julian Pohlan, MD

Radiology Case Reports (Aug 2021)

Atypical presentation of a locally advanced hepatocellular carcinoma: Extensive workup of an incidental finding on computed tomography performed for planning of transcatheter aortic valve implantation

Julia Lueg, MD,
Fabian Knebel, MD,
Ibrahim Awwad, MD,
Markus H. Lerchbaumer, MD,
Ute Fahlenkamp, MD,
Alexander Lembcke, MD,
Julian Pohlan, MD

Affiliations

Julia Lueg, MD: Department of Cardiology, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
Fabian Knebel, MD: Department of Cardiology, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
Ibrahim Awwad, MD: Deptartment of Gastroenterology, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
Markus H. Lerchbaumer, MD: Department of Radiology, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
Ute Fahlenkamp, MD: Department of Radiology, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
Alexander Lembcke, MD: Department of Radiology, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
Julian Pohlan, MD: Department of Radiology, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany; Corresponding author.

Journal volume & issue: Vol. 16, no. 8
pp. 2112 – 2118

Abstract

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This case report presents the diagnostic workup of liver malignancy incidentally detected in a 72-year-old male patient on routine body computed tomography angiography (CTA) performed for planning transcatheter aortic valve implantation (TAVI).The patient initially presented to an outside hospital with chest discomfort, where routine diagnostic procedures in the emergency room revealed grade III aortic valve stenosis.Routine CTA for TAVI planning in our department then revealed tumor thrombosis of the portal vein suspicious for hepatic malignancy.In contrast-enhanced ultrasound (CEUS) only the left hepatic lobe was inhomogeneously transformed with early arterial contrast enhancement. Magnetic resonance imaging (MRI) confirmed a primary hepatic malignancy involving the left liver. Transcutaneous biopsy with ultrasound guidance established the diagnosis of hepatocellular carcinoma (HCC).Incidental findings may be of prognostic relevance for the patient and in a number of cases, TAVI can be a prerequisite for the appropriate therapy.

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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