Paracaval pseudolipoma mimicking intracaval mass lesion and thrombus

Description 

A 53-year-old man presented with moderate dull non-radiating right upper quadrant pain for the past 1 month. There were no exacerbating or relieving factors or associated symptoms. His medical history was positive for hepatocellular carcinoma for which segmentectomy was performed 6 months ago. On physical examination, he was vitally stable and all systemic examinations were unremarkable. Contrast-enhanced abdominal CT scan showed an enhancing lesion at the surgical bed, representing recurrence of hepatocellular carcinoma (figure 1 and 2). There was also an apparently intracaval fat-density lesion in the suprahepatic part (figure 1 and 2). However, on detailed inspection, particularly on sagittal images (figure 3), its extracaval location became evident, and it was diagnosed as a paracaval pseudolipoma.

Figure 1

Contrast-enhanced CT scan axial section showing fat density compressing the inferior vena cava (IVC) representing paracaval pseudolipoma, mimicking...

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