Abstract
A 70-year-old Hispanic man with type II diabetes and alcoholic cirrhosis presented with dyspnea and abdominal distention. He had ascites, hepatosplenomegaly, and bilateral lower extremity edema. Bloodwork revealed sodium 123 mmol/L and creatinine 2.2 mg/dL, with model for end-stage liver disease score of 28. Paracentesis was performed with fluid analysis consistent with portal hypertension. Abdominal ultrasound showed a 5 × 4 cm right hepatic lobe mass. Contrast-enhanced triple-phase computed tomography showed a large 5-cm hypervascular tumor in the right liver (segment VII) with extension into the right and middle hepatic veins, and a 4.5-cm tumor in the right atrium (Figures A–C; arrows point to the area of interest) with enhancing components.
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