A Case of Solitary Necrotic Nodule Treated with Laparoscopic Hepatectomy: Spontaneous Regression of Hepatocellular Carcinoma?

Case Reports in Hepatology ◽

10.1155/2013/723781 ◽

2013 ◽

Vol 2013 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Hirokazu Tomishige ◽

Zenichi Morise ◽

Yoshikazu Mizoguchi ◽

Norihiko Kawabe ◽

Hidetoshi Nagata ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Benign Lesion ◽

Laparoscopic Hepatectomy ◽

Arterial Phase ◽

Elastic Fibers ◽

Abdominal Ultrasonography ◽

Surgical Specimen ◽

Reticulin Fibers ◽

Old Japanese ◽

Necrotic Nodule

Solitary necrotic nodule of the liver is a rare benign lesion with a completely necrotic core and a hyalinized fibrotic capsule containing elastic fibers. The pathogenetic mechanism is still unclear. We here describe a case of SNN, whose central reticulin fibers within the nodule suggest the origin as hepatocellular carcinoma or other hepatocyte-origin tumors, treated with laparoscopic anatomical segmentectomy of the liver. A 76-year-old Japanese female, with no prior medical history and no symptom, visited our hospital with the heterogeneous hypoechoic lesion in the liver segment VI incidentally pointed out in abdominal ultrasonography. Computed tomography with contrast demonstrated a 1.1 cm sized low-density lesion with mild ring enhancement on the rim in the arterial phase. Since the possibility of malignant tumor with necrotic change could not be ruled out, she underwent laparoscopic anatomical segmentectomy of the liver. In the histological examination of the surgical specimen, the liver nodule was necrotic tissue without viable cells and signs of inflammation, which had fibrous capsule and central cystic change and showed trabecular pattern alignment of ghost cells and reticulin fibers orthogonal to the capsule. Also, the findings of chronic hepatitis were observed in the background liver.

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Combined Primary Hepatic Neuroendocrine Carcinoma and Hepatocellular Carcinoma: Case Report and Literature Review

10.21203/rs.3.rs-96112/v1 ◽

2020 ◽

Author(s):

Akira Nakano ◽

Kenichi Hirabayashi ◽

Taro Mashiko ◽

Yoshihito Masuoka ◽

Seiichiro Yamamoto ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Neuroendocrine Carcinoma ◽

Somatostatin Receptor ◽

Correct Diagnosis ◽

Laparoscopic Hepatectomy ◽

Transitional Zone ◽

Arterial Phase ◽

Collision Type ◽

Microscopic Features ◽

The Right

Abstract Background: Hepatocellular carcinoma (HCC) can grow in a mosaic pattern, often combined with various non-hepatocellular cells. However, HCC combined with a neuroendocrine carcinoma (NEC) component is very rarely reported, and its clinical features, origin, diagnosis and behavior have not been established. In the literature, mixed HCC–NEC tumors are categorized as either collision type or combined type, depending on their microscopic features. Here we report a patient with a combined-type HCC–NEC tumor.Case presentation: An asymptomatic 84-year-old woman was found to have a solid mass in the right lobe of her liver. Laboratory and radiologic examinations showed findings typical of HCC, including arterial-phase enhancement, and portal- and delay-phase washout. She was preoperatively diagnosed with HCC, and treated with partial laparoscopic hepatectomy of her S5 segment. The tumor was 5.0 × 6.0 cm in diameter, and was predominantly HCC, partly admixed with a NEC component. A transitional zone between the HCC and NEC tissues was also observed. The tumor was finally diagnosed as a combined-type primary mixed NEC–HCC tumor. After the diagnosis, the patient underwent somatostatin receptor scintigraphy to look for the primary NEC lesion, but no accumulations were found in any other part of her body. She has been free of recurrence for 6 months since the surgery.Conclusion: Mixed HCC–NEC tumors are very rare. Correct diagnosis requires multidisciplinary collaboration. Accumulating cases is needed to help understand their exact pathology, diagnosis and treatment.

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Possible spontaneous regression of hepatocellular carcinoma with unique histopathological features confirmed by surgical resection: a case report

Surgical Case Reports ◽

10.1186/s40792-021-01246-z ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Toshihisa Kimura ◽

Takanori Goi ◽

Shigehiro Yokoi ◽

Kenji Ohnishi ◽

Tamotsu Togawa ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Spontaneous Regression ◽

Tumor Regression ◽

Histopathological Examination ◽

Equilibrium Phase ◽

Rare Event ◽

Resected Specimen ◽

Arterial Phase ◽

Abdominal Ultrasonography ◽

Programmed Death

Abstract Background Spontaneous regression of hepatocellular carcinoma (HCC) is a rare event, and its clinicopathological features and underlying mechanism are not fully understood. Case presentation An 84-year-old female with hepatitis C virus infection and diabetes mellitus was referred to our hospital for further examination. Abdominal ultrasonography showed a 3.4-cm solid tumor with a heterogeneous irregular center and no fibrous capsule in liver segment 8 (S8). An enhanced computed tomography (CT) scan revealed a tumor in S8 with heterogeneous enhancement in the arterial phase and washed out insufficiently in the portal and equilibrium phase. The enhanced pattern on magnetic resonance imaging was similar to that of CT. Although the imaging findings were not typical for HCC, liver resection (S8) was performed with HCC as the most probable diagnosis. Histopathological examination of the resected specimen showed that the tumor was well to moderately differentiated HCC with unique features. Approximately half of the tumor was composed of well-differentiated HCC that was focally accompanied by dense lymphocyte infiltration. The other half of the tumor was fibrotic tissue that resembled an inflammatory pseudotumor. Several foci of moderately differentiated HCC were scattered within the tumor with a nodule-in-nodule appearance, and the foci totally showed coagulative necrosis. On immunostaining, lymphocytes in the tumor stroma were positive for CD8 and programmed death 1. The expression of programmed death-ligand 1 was observed in carcinoma cells and macrophages specifically within the lymphocyte-rich area of HCC. Conclusions We consider this case representative of spontaneous regression of HCC, and the immune response against HCC might contribute to tumor regression, leading to complex histopathological appearances. This case may provide insight into the mechanism of spontaneous regression of HCC.

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Combined primary hepatic neuroendocrine carcinoma and hepatocellular carcinoma: case report and literature review

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02187-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Akira Nakano ◽

Kenichi Hirabayashi ◽

Hiroshi Yamamuro ◽

Taro Mashiko ◽

Yoshihito Masuoka ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Neuroendocrine Carcinoma ◽

Somatostatin Receptor ◽

Correct Diagnosis ◽

Laparoscopic Hepatectomy ◽

Transitional Zone ◽

Pathological Examination ◽

Arterial Phase ◽

Microscopic Features ◽

The Right

Abstract Background Hepatocellular carcinoma (HCC) can grow in a mosaic pattern, often combined with various non-hepatocellular cells. However, HCC combined with a neuroendocrine carcinoma (NEC) component is rarely reported, and its clinical features, origin, diagnosis, and behavior have not been established. In the literature, mixed HCC–NEC tumors are categorized as either collision type or combined type, depending on their microscopic features. Here, we report a patient with a combined-type HCC–NEC tumor. Case presentation An asymptomatic 84-year-old woman was found to have a solid mass in the right lobe of the liver. Laboratory and radiologic examinations showed typical findings of HCC, including arterial-phase enhancement, and portal- and delay-phase washout. She was treated by partial laparoscopic hepatectomy of segment 5. Pathological examination showed that the tumor was predominantly HCC, partly admixed with an NEC component. A transitional zone between the HCC and NEC tissues was also observed. The tumor was finally diagnosed as a combined-type primary mixed NEC–HCC tumor. After the preoperative diagnosis, the patient underwent somatostatin receptor scintigraphy to detect the primary NEC lesion, but no accumulation was found in any other part of her body. She has been free of recurrence for 9 months since the surgery. Conclusion Mixed HCC–NEC tumors are extremely rare, and correct diagnosis requires multidisciplinary collaboration. The accumulation of further cases is needed to help understand the exact pathology, diagnosis, and treatment of this disease.

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Combined primary hepatic neuroendocrine carcinoma and hepatocellular carcinoma: case report and literature review

10.21203/rs.3.rs-96112/v2 ◽

2021 ◽

Author(s):

Akira Nakano ◽

Kenichi Hirabayashi ◽

Hiroshi Yamamuro ◽

Taro Mashiko ◽

Yoshihito Masuoka ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Neuroendocrine Carcinoma ◽

Somatostatin Receptor ◽

Correct Diagnosis ◽

Laparoscopic Hepatectomy ◽

Transitional Zone ◽

Pathological Examination ◽

Arterial Phase ◽

Microscopic Features ◽

The Right

Abstract Background: Hepatocellular carcinoma (HCC) can grow in a mosaic pattern, often combined with various non-hepatocellular cells. However, HCC combined with a neuroendocrine carcinoma (NEC) component is rarely reported, and its clinical features, origin, diagnosis, and behavior have not been established. In the literature, mixed HCC–NEC tumors are categorized as either collision type or combined type, depending on their microscopic features. Here we report a patient with a combined-type HCC–NEC tumor.Case presentation: An asymptomatic 84-year-old woman was found to have a solid mass in the right lobe of the liver. Laboratory and radiologic examinations showed typical findings of HCC, including arterial-phase enhancement, and portal- and delay-phase washout. She was treated by partial laparoscopic hepatectomy of segment 5. Pathological examination showed that the tumor was predominantly HCC, partly admixed with an NEC component. A transitional zone between the HCC and NEC tissues was also observed. The tumor was finally diagnosed as a combined-type primary mixed NEC–HCC tumor. After the preoperative diagnosis, the patient underwent somatostatin receptor scintigraphy to detect the primary NEC lesion, but no accumulation was found in any other part of her body. She has been free of recurrence for 9 months since the surgery.Conclusion: Mixed HCC–NEC tumors are extremely rare and Correct diagnosis requires multidisciplinary collaboration. The accumulation of further cases is needed to help understand the exact pathology, diagnosis, and treatment of this disease.

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Intraoperative abdominal ultrasonography-guided large volume ethanol injection for hepatocellular carcinoma

Gastroenterology ◽

10.1016/s0016-5085(01)82388-x ◽

2001 ◽

Vol 120 (5) ◽

pp. A482-A482

Author(s):

R MONDRAGONSANCHEZ ◽

A GARDUOLOPEZ ◽

H MURRIETA ◽

M FRIASMENDIVIL ◽

R ESPEJO ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Large Volume ◽

Abdominal Ultrasonography ◽

Ethanol Injection

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Spiral CT of Hepatocellular Carcinoma: Correlation of CT Scans during the Arterial Phase with Angiography

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1996.34.4.507 ◽

1996 ◽

Vol 34 (4) ◽

pp. 507

Author(s):

Han Kyung Lee ◽

Byung Ihn Choi ◽

Joon Koo Han ◽

Dae Young Yoon ◽

Jae Min Cho ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Spiral Ct ◽

Ct Scans ◽

Arterial Phase

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miR-224 is an early-stage biomarker of hepatocellular carcinoma with miR-224 and miR-125b as prognostic biomarkers

Biomarkers in Medicine ◽

10.2217/bmm-2020-0099 ◽

2020 ◽

Vol 14 (15) ◽

pp. 1485-1500

Author(s):

Lichao Yang ◽

Chunmeng Wei ◽

Yasi Li ◽

Xiao He ◽

Min He

Keyword(s):

Hepatocellular Carcinoma ◽

Systematic Review ◽

Survival Analysis ◽

Sensitivity And Specificity ◽

Poor Prognosis ◽

Early Stage ◽

Meta Analysis ◽

Benign Lesion ◽

Diagnostic Efficiency ◽

Low Expression

Aim: The aim was to systematically investigate the miRNA biomarkers for early diagnosis of hepatocellular carcinoma (HCC). Materials & methods: A systematic review and meta-analysis of miRNA expression in HCC were performed. Results: A total of 4903 cases from 30 original studies were comprehensively analyzed. The sensitivity and specificity of miR-224 in discriminating early-stage HCC patients from benign lesion patients were 0.868 and 0.792, which were superior to α-fetoprotein. Combined miR-224 with α-fetoprotein, the sensitivity and specificity were increased to 0.882 and 0.808. Prognostic survival analysis showed low expression of miR-125b and high expression of miR-224 were associated with poor prognosis. Conclusion: miR-224 had a prominent diagnostic efficiency in early-stage HCC, with miR-224 and miR-125b being valuable in the prognostic diagnosis.

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A study on the inconsistency of arterial phase hypervascularity detection between contrast-enhanced ultrasound using sonazoid and gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid magnetic resonance imaging of hepatocellular carcinoma lesions

Journal of Medical Ultrasonics ◽

10.1007/s10396-021-01086-2 ◽

2021 ◽

Author(s):

Feiqian Wang ◽

Kazushi Numata ◽

Makoto Chuma ◽

Haruo Miwa ◽

Satoshi Moriya ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Hepatocellular Carcinoma ◽

Acetic Acid ◽

Magnetic Resonance ◽

Arterial Phase ◽

Contrast Enhanced Ultrasound ◽

Resonance Imaging ◽

Contrast Enhanced

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Differentiation between hepatocellular carcinoma and intrahepatic cholangiocarcinoma using contrast-enhanced ultrasound: A systematic review and meta-analysis

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-211145 ◽

2021 ◽

pp. 1-17

Author(s):

Yanling Chen ◽

Wenping Wang

Keyword(s):

Hepatocellular Carcinoma ◽

Diagnostic Accuracy ◽

Publication Bias ◽

Likelihood Ratio ◽

Intrahepatic Cholangiocarcinoma ◽

Cochrane Library ◽

Arterial Phase ◽

Contrast Enhanced Ultrasound ◽

Diagnostic Ability ◽

Contrast Enhanced

AIM: To explore the diagnostic ability of contrast-enhanced ultrasound (CEUS) in distinguishing intrahepatic cholangiocarcinoma (ICC) from hepatocellular carcinoma (HCC). MATERIALS AND METHODS: PubMed, EMBASE, Cochrane Library, and Web of Science were systematically searched for studies reporting the diagnostic accuracy of CEUS in differentiating ICC from HCC. The diagnostic ability of CEUS was assessed based on the pooled sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and area under the curve (AUC) with 95% confidence intervals (CIs). The methodologic quality was assessed by the QUADAS-2 tool. Subgroup analyses, meta-regression and investigation of publication bias were performed to identify the source of heterogeneity. RESULTS: A total of eight studies were included, consisting of 1,116 patients with HCC and 529 with ICC. The general diagnostic performance of CEUS in distinguishing ICC and HCC were as follows: pooled sensitivity, 0.92 (95% CI: 0.84–0.96); pooled specificity, 0.87 (95% CI: 0.79–0.92); pooled PLR, 7.1 (95% CI: 4.1–12.0); pooled NLR, 0.09 (95% CI: 0.05–0.19); pooled DOR, 76 (95% CI: 26–220) and AUC, 0.95(95% CI: 0.93–0.97). Different liver background may be a potential factor that influenced the diagnostic accuracy of CEUS according to the subgroup analysis, with the pooled DOR of 89.67 in the mixed liver background group and 46.87 in the cirrhosis group, respectively. Six informative CEUS features that may help differentiate HCC from ICC were extracted. The three CEUS features favoring HCC were arterial phase hyperenhancement(APHE), mild washout and late washout (>60s); the three CEUS favoring ICC were arterial rim enhancement, marked washout and early washout(<60s). No potential publication bias was observed. CONCLUSION: CEUS showed great diagnostic ability in differentiating ICC from HCC, which may be promising for noninvasive evaluation of these diseases.

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