Hepatocellular Carcinoma Presenting as a Wandering Abdominal Lump with Atypical CEUS

Introduction

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors occurring worldwide, most of which are secondary to either viral hepatitis (type B or C) or cirrhosis with variant causes. Some of the clinical signs and symptoms include jaundice, ascites, weight loss, and abdominal pain. Patients with rising alpha-fetoprotein and the above-mentioned situations should be considered with a higher suspicion for HCC. In these cases, various imaging modalities, including CT, MRI and ultrasonography, have been used for diagnoses, and often include the application of intravenous contrast agents. Contrast-enhanced ultrasound (CEUS) has been recommended for several applications by the guidelines of several societies and is currently accepted as a reliable imaging method for the diagnosis and evaluation of HCC (Claudon M et al. Ultraschall in Med, Online Publication: 2012: DIO 10.1055/s-0032-1325499). The following is a report of HCC with rare clinical and CEUS presentations.