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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Orbital metastases of hepatocellular carcinoma are rare. The authors report a case of hepatocellular carcinoma metastatic to the orbit. A 56-year-old woman with hepatitis B infection as confirmed serologic test for hepatitis B surface antigen (HBsAg) demonstrated superior displacement of the left eyeball. The clinical appearance of the patient demonstrated an inferior displacement of the right eye. MRI disclosed an orbital mass that extended toward the lower eyelid and into the temporal fossa with destruction of the lateral orbital wall. Upon subsequent abdominal computed tomographic scans, the primary tumor was found in the liver. A biopsy specimen of the orbit showed trabecular structures with eosinophilic cytoplasm. Bile canaliculi and sinusoids were also seen. The tumor cells showed vesicular nuclei with mitoses. Immunohistochemical markers such as high-molecular-weight keratin and alpha-fetoprotein showed a positive response. However, immunohistochemical markers such as low-molecular-weight keratin and polyclonal carcinoembryonic antigen showed as negative. We diagnosed the tumor as a hepatocellular carcinoma metastatic to the orbit. A review of the pertinent literature disclosed relatively few occurrences of hepatocellular carcinoma metastasizing to the orbit.
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PMID:Hepatocellular carcinoma metastatic to the orbit. 1121 42

Metastatic tumours involving the nose and the paranasal sinuses are rare. Especially metastatic spread to the sphenoid sinus is an extremely rare occurrence. The most common metastatic tumour is the renal cell carcinoma. Only four cases of hepatocellular carcinoma presenting a sphenoid sinus metastasis could be found in a search of the literature. We report on the case of a 59-year-old male who suffered from a sphenoid sinus mass. A biopsy showed the tumour to be a metastatic hepatocellular carcinoma. The suspected primary tumour was then found in the left liver lobe. The early diagnosis of paranasal sinus malignancies is difficult because of the varied and nonspecific symptoms and signs. In cases of late diagnosis, the treatment is usually palliative with a poor prognosis. The importance of endoscopic examination and CT or MRI scan for early detection must be emphasized.
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PMID:[Metastasis in the frontal skull base from hepatocellular carcinoma]. 1127 Jan 94

The objective of this study was to evaluate the therapeutic effectiveness of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) with dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSC-MRI). Seventeen patients with histopathologically proven HCC were included in this study. All patients underwent MR examinations with conventional T1- and T2-weighted images, gadolinium-enhanced images, and DSC-MRI before TACE treatment. Hepatic blood volume (HBV) maps were reconstructed from the time-intensity curves. The same MRI sequences and techniques were repeated 24 h and 6 weeks after TACE. Serial changes in tumor perfusion on HBV maps were correlated with vascularity in hepatic angiography. All tumors were hypointense on T1-weighted images and hyperintense on T2-weighted images. Heterogeneous enhancement was observed in all tumors before and immediately after TACE. Hyperperfusion was noted in most of the tumors on HBV map before TACE and moderate to marked hypoperfusion following TACE. The degree of tumor perfusion on HBV map correlated well with the vascularity in angiography. In conclusion, the noninvasive nature of DSC-MRI is useful to evaluate the effectiveness of TACE. Invasive procedures, such as angiography, are seldom necessary.
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PMID:Evaluation of therapeutic effectiveness of transarterial chemoembolization for hepatocellular carcinoma: correlation of dynamic susceptibility contrast-enhanced echoplanar imaging and hepatic angiography. 1127 85

Lipomas of the major central veins are rare, and their sonographic features have rarely been reported. We report a case in which a lipoma of the inferior vena cava (IVC) was incidentally identified during liver sonography in a 68-year-old man. Sonography of the upper abdomen revealed coarsening of the liver echotexture, with a relatively small liver and atrophy of the right hepatic lobe. A 2-cm hypoechoic hepatic nodule was visualized in segment IV. Sonography also showed a 2.2- x 1.8-cm, highly echogenic, homogeneous nodule in the hepatic segment of the IVC at its junction with the right atrium. The lumen of the IVC was partially occluded. The CT and MRI appearances of the IVC lesion were consistent with a lipoma, which was not treated because there was no clinical evidence of obstruction. Histopathologic analysis following a sonographically guided biopsy of the liver nodule revealed hepatocellular carcinoma, which was treated by percutaneous ethanol injection.
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PMID:Sonographic appearance of lipoma of the inferior vena cava. 1180 58

This paper gives a comprehensive overview of ultrasound of focal liver lesions. Technical aspects such as examination technique and the use of Doppler modes as well as recent developments such as tissue harmonic imaging and microbubble contrast agents are discussed. The clinical significance and sonographic features of various liver lesions such as haemangioma, focal nodular hyperplasia, adenoma, regenerative nodule, metastasis, hepatocellular carcinoma and various types of focal infections are described. With the exception of cysts and typical haemangiomas, definitive characterisation of a liver lesion is often not possible on conventional ultrasound. This situation has changed with the recent advent of ultrasound contrast agents, which permit definitive diagnosis of most lesions. Contrast-enhanced sonography using recently developed contrast-specific imaging modes dramatically extends the role of liver ultrasound by improving its specificity in the detection and characterisation of focal lesions to rival CT and MRI.
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PMID:Ultrasound of focal liver lesions. 1151 77

A boy with Alagille syndrome complicated by hepatic nodular hyperplasia (HNH) is reported. During pre-transplantation evaluation, CT and MRI revealed a large hepatic lesion with multiple small nodular lesions. Angiography demonstrated a large hypervascular lesion and CT arterial portography (CTAP) showed a portal perfusion defect corresponding to the lesion. CTAP also revealed large portal vein branches running through the lesion. Although hepatocellular carcinoma is known to accompany Alagille syndrome, HNH should also be considered when large vessels running through the lesion are demonstrated.
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PMID:Hepatic nodular hyperplasia in a boy with Alagille syndrome: CT and MR appearances. 1155 Jul 72

A 52-year-old male had hepatocellular carcinoma (HCC), located just above the main trunk of the right hepatic vein. Firstly, this patient was treated by TAE. However, the effect was incomplete, so the patient was referred to Kurashiki Medical Center for additional therapy. Microwave coagulation therapy (MCT) under laparotomy was performed due to the deterioration of hepatic functional reserve. The level of AFP decreased to the normal range. Recurrent HCC was found at medial segment of the liver by MRI taken seven months after the first MCT. MCT was performed again intraoperatively. The main trunk of the right hepatic vein was proved to be patent by enhanced CT. Furthermore, this patient has lived without tumor recurrence for 34 months after the second MCT. This case shows that MCT is a useful method to treat HCC located near the main hepatic vein.
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PMID:[A long-term survivor undergoing microwave coagulation therapy for hepatocellular carcinoma located just above the main trunk of right hepatic vein]. 1181 72

AIM:To compare and analyze the contrast enhancement appearance of small hemangioma (SHHE) and small hepatocellular carcinoma (SHCC) with helical multi-phase CT scanning so as to determine their roles and pitfalls in the differential diagnosis of SHHE and SHCC.METHODS:The pre and postcontrast CT scanning of the liver in 73 cases (38 SHHE, 35 SHCC) were carried out. The first phase scan of the entire liver began at 30s after the injection of contrast medium, the second and third phases began at 70s, and 4min respectively. The contrast enhancement patterns and characteristics of all lesions were observed and compared.RESULTS In SHHE, 64.29% (27/42) had typical manifestations in two-phase dynamic scanning, such as peripheral dramatic high-density enhancement of the lesions with progressive opacification from the periphery toward the center, 30.95% (13/42) were hyperdense in both phases and 4.76% (2/42) were hypodense in both phases. In the third phase scanning, 96.67% (28/30) of SHHE were hyperdense and isodense.In SHCC 59.52% (25/42) presented typical appearances, such as hyperdense in the first phase and hypodense in the second phase, 23.81% (10/42) were hyperdense in the first phase and isodense in the second phase with 4.76% (2/42) of hypodense in both phases. In the third phase scanning, 85.71% (24/28) of SHCC were hypodense.CONCLUSION:According to the contrast enhancement patterns of SHHE and SHCC in the two-phase or multi-phase scanning by helical CT, diagnosis can be established in the majority of lesions, while some atypical cases needed MRI for further investigation.
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PMID:Role and pitfalls of hepatic helical multi-phase CT scanning in differential diagnosis of small hemangioma and small hepatocellular carcinoma. 1181 17

Since a close relationship exists between intranodular hemodynamics and the grade of biological/pathological malignancy of a nodule occurring in the cirrhotic liver, an accurate evaluation of intranodular hemodynamics is highly essential. Intranodular hemodynamics in hepatocellular carcinoma (HCC) and borderline lesions can be evaluated correctly by invasive and noninvasive techniques. Invasive techniques such as ultrasound (US) angiography, computed tomographies during arteriography or arterial portography are sensitive in the detection of intranodular arterial and portal supplies, for accurate diagnosis of tumors and assessing grades of biologically malignant potential. However, these approaches require an angiographic procedure, which is not always available. Recently, perfusion imaging techniques under US, including contrast-enhanced harmonic imaging or real-time gray-scale harmonic imaging, have become available for routine clinical use. With these techniques, all the five roles of imaging in the management of HCC, i.e., detection, confirmation, staging, evaluation of malignancy grade, and postoperative follow-up, have become much simpler. Perfusion imaging techniques have reduced the requirement for dynamic CT or MRI and may replace some of their roles in the clinical setting. Since viable cancer cells are accurately imaged on US monitoring with sensitive perfusion imaging techniques, the contrast-enhanced harmonic imaging will be of great advantage in US-guided treatment of HCC. With the advent of rapid and remarkable advances in US harmonic imaging techniques, the diagnostic and therapeutic strategies for HCC are changing drastically.
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PMID:Imaging blood flow characteristics of hepatocellular carcinoma. 1186 85

Hepatocarcinogenesis in the cirrhotic liver has recently become a subject of intense investigation. The development of hepatocellular nodules demonstrating varying degrees of cellular and architectural atypia suggests that these nodular lesions represent a pathway of carcinogenesis in cirrhosis of different etiologies. This pathway involves processes, such as capillarization and neoangiogenesis, leading to a gradual change in blood supply from portal to arterial, as a dysplastic nodule becomes hepatocellular carcinoma. These changes in intranodular blood supply create different enhancement patterns in the two phases of liver circulation after an intravenous contrast injection on multi-phase helical CT or dynamic gadolinium-enhanced MRI. This article reviews the current concepts regarding the vascular changes occurring in dysplastic nodules in the multistep process of hepatocarcinogenesis, along with the associated imaging manifestations. Some practical issues and dilemmas regarding the follow-up and biopsy of these lesions are also discussed.
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PMID:The multistep process of hepatocarcinogenesis in cirrhosis with imaging correlation. 1196 Feb 22


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