Abstract

A 60-year-old man with a history of congenital intrahepatic portosystemic shunt (CIPS) presented with acute bilateral lower-extremity edema. There were no stigmata of chronic liver disease. However, mildly abnormal liver function tests and α-fetoprotein 79.1 ng/mL were noted. Subsequent imaging revealed a 8 cm right lobe liver mass, extending into the right hepatic vein into the IVC and right atrium (A,B). An 8 mm side-to-side intrahepatic shunt between the right portal vein and the IVC (C,D – CT; E - US) was confirmed.

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