01/09/2012
NCKUH case
- Case Overview
- Diagnosis
Age:
50
Sex:
female
Condition:
50 y/o female, DM(+), HTN(+), HBV carrier
She was told that she had a hepatic mass found from abdominal echo(2011/08). Abnormal liver function was also noted.
She visited our oncology OPD(2011/09)
AST: 71, ALT: 108, AFP: 43.13
Abdominal CT: two hepatic tumors at S4 & S5
She was transferred to GS OPD → suggest admission for further evaluation and treatment.
She was told that she had a hepatic mass found from abdominal echo(2011/08). Abnormal liver function was also noted.
She visited our oncology OPD(2011/09)
AST: 71, ALT: 108, AFP: 43.13
Abdominal CT: two hepatic tumors at S4 & S5
She was transferred to GS OPD → suggest admission for further evaluation and treatment.
History:
DM(+), HTN(+), under medical control
HBV carrier
OP history: TAH + oophorectomy
HBV carrier
OP history: TAH + oophorectomy
Note:
Image findings:
CT
Two hepatic tumors as 2.7cm in size on S4 (Tumor B) and 2.7cm in size on S5 (Tumor A). →favored HCC
MRI
Two nodules
about 2.5cm at S4 (Tumor B) .
about 2.5cm at S5, which is decreased signal in out-of-phase, favor fat component (Tumor A) .
CT
Two hepatic tumors as 2.7cm in size on S4 (Tumor B) and 2.7cm in size on S5 (Tumor A). →favored HCC
MRI
Two nodules
about 2.5cm at S4 (Tumor B) .
about 2.5cm at S5, which is decreased signal in out-of-phase, favor fat component (Tumor A) .
Comments
A - appers like focal nodular hyperplasia
B- is hepatocellular carcinoma
A - appers like focal nodular hyperplasia
B- is hepatocellular carcinoma
hepatocellular carcinoma,different degrees of differentiation for hepar1 or p CEA
HCC
Do reticulin stain and also Hep-par1 to confirm diagnosis. Can also do polyclonal CEA or CD34.
Totally agree :)
previous TAH and BSO for what??
T1 seems to be well differentiated HCC (clear cell variant) for Hep-par1 to confirm, while T2 may be 1ry less differentiated HCC or metastatic also for Hep-par1 to confirm.