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Image of the Month—Quiz Case
Ajay Jain, MD;
Christopher Smith, MD;
Jean-Francois H. Geschwind, MD;
Timothy M. Pawlik, MD, MPH
Arch Surg. 2009;144(3):285.
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INTRODUCTION
An 85-year-old man with a medical history of hypertension, coronary artery disease, diabetes, chronic renal insufficiency, and alcohol abuse presented with a chief complaint of heartburn and back pain. Right upper quadrant ultrasonography was performed to evaluate for gallstones, but instead it revealed a mass in the left lobe of the liver abutting the stomach. Magnetic resonance imaging of the abdomen (Figure 1) revealed a large (7.5-cm) mass in the left lateral section of the liver, which was confirmed to be hepatocellular carcinoma (HCC) by ultrasonography-guided biopsy. The patient was considered a poor surgical candidate owing to significant medical comorbidities. He was therefore referred for hepatic transarterial chemoembolization (TACE) of the tumor. There was a good response to TACE therapy, with near-complete necrosis of the tumor. The patient tolerated the procedure and initially . . . [Full Text of this Article]
What Is the Diagnosis?
Author Affiliations: Departments of Surgery (Drs Jain and Pawlik), Radiology (Dr Smith), and Cardiovascular and Interventional Radiology (Dr Geschwind), Johns Hopkins School of Medicine, Baltimore, Maryland.
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Arch Surg. 2009;144(3):286.
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