Differential Diagnosis for a 2.5-centimeter Encapsulated Solid Lesion in a Patient with Cirrhosis
- Single most likely diagnosis
- Hepatocellular carcinoma (HCC): This is the most likely diagnosis given the patient's underlying cirrhosis due to hepatitis C, the size of the lesion (2.5 cm), and the imaging characteristics (arterial phase hyperenhancement and delayed venous washout). These features are classic for HCC, especially in the context of a high-risk patient.
- Other Likely diagnoses
- Hepatocellular adenoma: Although less likely than HCC, hepatocellular adenoma could present with similar imaging characteristics, including arterial phase hyperenhancement. However, adenomas are typically seen in younger patients without cirrhosis and are associated with different risk factors (e.g., oral contraceptive use).
- Do Not Miss diagnoses
- Intrahepatic cholangiocarcinoma: While less common than HCC in cirrhotic patients, intrahepatic cholangiocarcinoma can present with similar imaging features and is important not to miss due to its aggressive nature and different treatment approach.
- Rare diagnoses
- Vocal nodular hyperplasia: This option is not relevant to the liver or the clinical scenario presented, suggesting it might be a typographical error or misplaced option. Other rare diagnoses that could be considered but are not listed include metastatic disease to the liver (from another primary cancer), hepatic lymphoma, or other rare liver tumors, but these would be less likely given the provided clinical context and imaging characteristics.