Hepatocellular Carcinoma (HCC) with Portal Vein Invasion, Masquerading as Pancreatic Mass, Diagnosed by Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA)

Excerpt

Hepatocellular carcinoma (HCC) is a common cause of death among patients with cirrhosis, with epidemiologic data suggesting that the mortality rate in the United States is on the rise [1]. Although screening for HCC ultrasound and AFP every 6 months in patients with cirrhosis is recommended for early detection, small lesions are often missed. Portal vein thrombosis secondary to HCC invasion often results in clinical decompensation and is a contraindication to resection or liver transplantation [2]. As portal vein thrombosis secondary to clot is common among patients with cirrhosis, determination of a clear etiology is important in these patients. We report a case of HCC with portal vein thrombosis mimicking pancreatic cancer. The diagnosis was made by endoscopic ultrasound (EUS) and the presence of tumor thrombus in the portal vein was confirmed by fine needle aspiration (FNA). …