Authors:
M. A. Hernandes, J. Elias Jr, A. C. Teixeira, V. F. Muglia, M. Koenigkam-Santos, F. F. Souza, A. L. C. Martinelli, A. K. Sankarankutty, O. Castro e Silva; Ribeirão Prêto/BR
DOI:
10.1594/ecr2010/C-0030
Conclusion
1. Diffuse-type HCC imaging, clinical and laboratory findings in our study were similar to those described in the literature [1,3].
2. Despite the fact that ultrasound is the method used in the majority of HCC screening programs, its accuracy for the diffuse-type HCC is lower when compared with published data on solitary and multifocal HCC types [7]. This can lead to a delayed diagnosis and worse prognosis.
3. Identification of vascularized expansive portal vein thrombosis in patients with diffuse liver disease with no defined hepatic mass lesion should indicate the possibility of diffuse-type of HCC (fig. 1,2,3).
4. MR imaging with dynamic postcontrast technique is the most accurate method for detection and characterization of the diffuse type HCC [3] (fig. 4).
5. Small infiltrative HCC type seems to have a better prognosis compared to disseminated HCC type, although further studies are needed to confirm this finding.
6. Diffuse type HCC diagnosis remains a challenge for all imaging methods. It is also a well-known cause of delayed HCC diagnosis in surveillance protocols of chronic hepatic disease patients. Recognition of diverse imaging features of this tumor is paramount to make an earlier diagnosis. Small infiltrative HCC is a rare and distinct presentation of diffuse-type HCC and can be diagnosed by MRI.