24 August 2026
: Case report 
Refractory Hyperammonemic Encephalopathy as a Paraneoplastic Presentation of Fibrolamellar Hepatocellular Carcinoma: A Case Report
Management of emergency care, Rare disease
Ritwik Dey
ABDEF 1*, Harshitha Popuri ABDEF 1, Virali Gulla BDEF 1, Yagnapriya Chirrareddy EF 1, Satyapriya Paritala EF 1, Daniel Bustamante ABDE 2, Javier Corral ABDEF 3
DOI: 10.12659/AJCR.952819
Am J Case Rep 2026; 27:e952819
Figure 2 Contrast-enhanced computed tomography (CT) demonstrates widespread metastatic disease and thrombotic complications. Axial CT images show (A) a large intracardiac mass within the right ventricle (red star); (B) a 7.6 × 7.9 cm hepatic mass (yellow arrow) with additional intraperitoneal tumor deposits (yellow star); (C) a pelvic mass (red arrow); and (D) deep vein thrombosis in the right common femoral vein (blue arrow).