Surgical resection of a solitary para-aortic lymph node metastasis from hepatocellular carcinoma

Figure 1 An abdominal computed tomography angiographic scan, showing a diffuse high-density area. A: An abdominal computed tomography angiographic scan including a lesion previously treated by radiofrequency ablation in segment 8 of the right hepatic lobe, in the arterial phase (arrow); B: The area was washed out on late-phase images (arrow).

Figure 2 Histopathological examination revealed the presence of considerable necrosis and fibrosis in the tumor. The hepatocellular carcinoma (HCC) was graded as moderate-grade funicular type. A: Poorly differentiated HCC was present in some regions; B: Peripheral portal vein invasion was detected (hematoxylin and eosin, ×600).

Figure 3 An enhanced computed tomographic scan of the abdomen revealed a tumor (20 mm in diameter, arrow) on the right side of the abdominal aorta.

Figure 4 Fluorine-18 fluorodeoxyglucose positron emission tomography revealed that the tumor had an elevated standard uptake value (arrow).

Figure 5 Histopathological examination revealed that the tumor consisted of a broad region of necrosis with poorly differentiated hepatocellular carcinoma on its surface (hematoxylin and eosin, ×600).