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Clinical History: Patient with known tumor presents with elevated liver enzymes.
Findings: Numerous tumor masses and lymph nodes in the porta hepatis, with several small metastatic lesions. Scan shows enhancement of the portal vein. Partial narrowing of the medial portal vein is seen by the adjacent tumor masses. Small vessels are noted in the anterior abdomen by the stomach which represent varices.
Diagnosis: Metastatic disease to the liver.
Discussion: Metastatic disease to the liver is a very common process. It is unusual to have a limitation of the blood supply by encasement of the portal vein system. High dose contrast injection coupled with dynamic scanning is a very helpful for diagnosing abnormalities of the portal system.
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