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RADIOLOGY: HEPATOBILIARY: Case# 32794: HEPATOCELLULAR CARCINOMA & CIRRHOSIS. 63 year old man with history of hepatitis C and cirrhosis. He presents with increasing billirubin. 1. Cirrhotic morphology. Extremely heterogeneous attenuation with multiple focal areas of low attenuation suspicious for hepatocellular carcinoma. The right portal vein branch is not well seen, possibly secondary to compression by adjacent liver parenchyma versus infiltration by tumor. The hepatic veins are also not well seen. Retroperitoneal adenopathy and enlarged right adrenal gland suspicious for metastatic disease.2. Recannulated umbilical vein, shunting blood past the liver and into the left iliac venous circulation.

Peter Anderson