Imaging features of hepatic sarcomatous carcinoma

Authors: Kyowon Gu Young Kon Kim Ji Hye Min Sang Yun Ha Woo Kyoung Jeong

Publish Date: 2017/01/12

Volume: 42, Issue: 5, Pages: 1424-1433

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Abstract

To determine the imaging features of hepatic sarcomatous carcinoma including sarcomatous intrahepatic cholangiocarcinoma SICC and sarcomatous hepatocellular carcinoma SHCC on computed tomography CT and gadoxetic acidenhanced magnetic resonance imaging MRITwentyfour patients with pathologically confirmed SICCs n = 13 SHCCs n = 7 sarcomatous carcinoma n = 2 carcinosarcoma n = 1 and sarcomatous combined HCC–CC n = 1 size range 21–23 cm mean 83 cm underwent gadoxetic acidenhanced MRI n = 20 and/or dynamic CT N = 24 Underlying chronic hepatitis or cirrhosis was found in 17 patients Two reviewers evaluated morphology signal intensity and enhancement features of tumors based on a consensusLobulated contour was observed in 15 tumors 625 the rest were round or oval masses During dynamic imaging SICCs showed poor enhancement n = 10 on CT n = 7 on MRI or initial thinrim enhancement with/without progressive enhancement n = 3 on CT n = 6 on MRI SHCCs and the other four tumors showed a thin or thick enhancement pattern on both CT and MRI T2 bright signal intensity similar to fluid was found in 10 tumors Target appearance on hepatobiliary phase and diffusionweighted imaging was seen in two SICCs and two SHCCs Of 18 surgically resected tumors 17 showed vascular invasion and/or thrombosis in histology and 12 in CT and MRI Ten tumors were accompanied by intrahepatic metastasis or tumor seeding and 19 patients had recurrence or progression of tumors during followupHepatic sarcomatous carcinoma including SHCC and SICC generally presents minimal rimlike arterial enhancement or extreme hypovascularity on CT and gadoxetic acidenhanced MRI with a high frequency of T2 bright area due to extensive necrosis and vascular invasionAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards For this type of study formal consent is not required

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