Bone metastases as initial presentation of hepatocellular carcinoma

Figure 3 Clinical case 3. A: Multiphasic liver MDCT showing a well-defined hepatic focal lesion in segment VII (white arrow) with heterogeneous enhancement in the arterial phase; B: Multiphasic liver MDCT showing the lesion with clear washout in the portal phase (white arrow); C: Multiphasic liver TCMD showing the lesion as markedly hypodense in the delayed phase; D, E: Lumbar MRI, sagittal T1-weighted and sagittal T2-weighted, showing pathological fracture of the fourth lumbar vertebrae with posterior wall displacement and vertebral channel invasion; F: Surgical specimen, a hemorrhagic biopsy, showing isolated metastatic groups constituted by hepatocytes after staining with hematoxylin-eosin (20 × magnification). MDCT: Multidetector computed tomography; MRI: Magnetic resonance imaging.