A liver tumor that progressed to hepatocellular carcinoma as observed on follow-up magnetic resonance images showing increased contrast medium uptake

Abstract

We present the case of a 59-year-old male with chronic hepatitis C. An ischemic low-signal intensity nodule was detected on hepatocyte-phase images at S8 obtained by gadolinium-ethoxybenzyl-diethylene-triaminepentaacetic acid (Gd-EOB-DTPA) -enhanced magnetic resonance imaging (MRI). The nodule remained unchanged in size but showed a high-intensity signal on hepatocyte phase images. Subsequently, the nodule increased in size, and dynamic computed tomography revealed hyperemic changes, suggestive of hepatocellular carcinoma. Hepatectomy was performed, and histopathological examination of the resected specimen revealed a bile-producing, moderately differentiated, hepatocellular carcinoma. Cell membrane expression of OATP1B3 was detected in the cancerous area, which was more densely stained than the noncancerous areas. We followed the clinical course of the patient, who gradually developed a green hepatoma, which presented as an ischemic low-signal intensity nodule that was detectable only on hepatocyte-phase images obtained by Gd-EOB-DTPA-enhanced MRI. We observed a gradual increase in size, hyperemic changes, and a shift to a high-intensity signal on the hepatocyte-phase images.