Published online Nov 21, 2014. doi: 10.3748/wjg.v20.i43.16377
Revised: April 22, 2014
Accepted: July 22, 2014
Published online: November 21, 2014
Calcification of the portal venous system is a rare entity that can be incidentally discovered during computed tomography (CT). We describe a case of extensive calcifications in the portal venous system in a middle-aged male patient with hepatocellular carcinoma (HCC). This patient presented with epigastric pain that had no obvious origin prior to admission. Laboratory examinations were positive for hepatitis B surface antigen and α-fetoprotein, and severe esophageal and gastric varices were detected during gastroscopy. Abdominal X-ray plain film showed well-defined linear and track-like calcification, with irregular margins directed along the course of the portal venous system. CT revealed extensive calcifications along the course of the portal, splenic, superior mesenteric and gastroesophageal veins. He underwent splenectomy 22 years ago due to splenomegaly and partial hepatectomy seven months before because of HCC of low-grade differentiation, confirmed by pathology. Finally, the patient was diagnosed with postoperative recurrent HCC and extensive portal venous system calcification after selective hepatic angiography under digital subtraction angiography.
Core tip: We reported a case of extensive calcifications in portal venous system combined with hepatocellular carcinoma (HCC) in a middle-aged man. He underwent splenectomy 22 years ago for splenomegaly and partial hepatectomy 7 mo before due to HCC. Extensive calcifications along the course of the portal vein were found on computed tomography.