Differentiation of metastatic follicular thyroid cancer from hepatocellular carcinoma using Hep Par 1.

Hepatocellular carcinoma usually arises in a cirrhotic liver. Multiple hepatic nodules in a non-cirrhotic liver are more likely to be metastatic. The primary focus commonly arises from the gastrointestinal tract, breast or lung, but in the absence of these a primary liver pathology must be considered. The case is reported of a middle-aged woman presenting with multiple nodules on computed tomography with no clinically apparent primary for whom results of initial diagnostic investigations were potentially misleading.