Surgical treatment of hepatocellular carcinoma with severe intratumoral arterioportal shunt

Figure 1 Computed tomography examination. A: Low-density lesion in the posterior segment of the liver, which pressed the vena cava and right hepatic vein and opposed the right anterior superior portal vein; B: Hyper-enhanced portal vein during the arterial phase; C: Tumor thrombus in the posterior branch of the portal vein. A tumor opposed the right anterior inferior portal vein.

Figure 2 Upper gastrointestinal endoscopy revealing severe esophageal varices.

Figure 3 Arteriography. A: Right hepatic arteriography exhibiting the right portal vein, caused by severe intratumoral arterioportal shunt; B: Transarterial portography revealing non-enhancement of the portal vein because of portal hypertension.