Hepatocellular carcinoma presenting as primary extrahepatic mass on CT

Seven cases of hepatocellular carcinoma (hepatoma) (HCC) presenting as primary extrahepatic masses on CT are reported. All cases were diagnosed at the time of percutaneous biopsy, surgical resection, or autopsy. In none of the cases was the final diagnosis of HCC prospectively suspected on the basis of clinical and radiologic findings. Although three of the patients were at higher risk for development of HCC because of their medical histories, the absence of an elevated serum alpha-fetoprotein level and the extrahepatic location of the masses by CT suggested other disease. This variable pattern of radiologic presentation of HCC should be kept in mind during the evaluation of patients with suspected HCC, or when the findings on abdominal/pelvic CT of mass and presumed hepatic metastases are at variance with the clinical presentation.