Bulky, Solitary Hepatocellular Carcinoma

A 72-year-old man with a history of alcohol-related cirrhosis, coronary artery disease, hypertension, chronic obstructive pulmonary disease, hyperlipidemia, and chronic lymphocytic leukemia on surveillance presented with abdominal pain. Computed tomography of the abdomen/pelvis showed a mass in the left lobe of the liver. Magnetic resonance imaging confirmed a solitary, exophytic 5.1-cm mass in the left lobe, involving segments 2 and 3, with arterial-phase enhancement, washout on delayed phase imaging, and pseudocapsule, consistent with a diagnosis of hepatocellular carcinoma (HCC) by meeting Liver Imaging and Reporting Data System (LI-RADS) 5 criteria (Fig.