To evaluate a hepatic nodule in a 74-year-old man with metabolic dysfunction and alcohol-related liver disease.
Approach:
Patient Evaluation: A 74-year-old man with a 5.3-cm hepatic nodule was evaluated using serologic testing, liver function tests, and imaging studies.
Imaging and Diagnosis: Dynamic contrast-enhanced MRI indicated arterial phase hyperenhancement and washout, leading to a preliminary diagnosis of hepatocellular carcinoma (HCC).
Surgical Intervention: The patient underwent laparoscopic left hemihepatectomy for diagnostic confirmation and curative intent.
Histopathological Analysis: Histopathology confirmed the diagnosis of a primary hepatic gastrointestinal stromal tumor (GIST) through immunohistochemical staining.
Key Findings:
The hepatic nodule exhibited imaging features consistent with LI-RADS 5, typically associated with HCC.
Primary hepatic GISTs are rare, with only about 40 cases reported in literature.
Interpretation:
Despite typical HCC imaging features, the diagnosis was a rare primary hepatic GIST, highlighting the need for differential diagnosis in chronic liver disease.
Limitations:
The rarity of primary hepatic GISTs may limit the generalizability of findings to broader populations.
Imaging characteristics of hepatic GISTs are not well-defined, complicating accurate diagnosis.
Conclusion:
Primary hepatic GIST should be considered in the differential diagnosis of liver nodules in patients with chronic liver disease, even when imaging suggests HCC.
The goal of this clinical trial is to learn if Adaptive Radiation Therapy (ART) is safe and effective in treating patients with locally advanced pancreatic cancer.
