Extrahepatic Vascular Parasitization by a Hepatocellular Carcinoma

Hepatocellular carcinoma is the most common primary hepatic malignancy. For patients not amenable to surgical treatment, transarterial chemoembolization is a viable therapeutic alternative. Extrahepatic collateral arterial supply to the tumor may occur in a variety of scenarios and timely detection of this phenomenon is of fundamental importance to achieve optimal outcomes and response to treatment. This report presents a case of hepatocellular carcinoma that was supplied mainly by a parasitized right phrenic artery and was only successfully treated once this was identified. Further discussion of extrahepatic collateral arterial supply is also presented.