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
Methods and Materials
Patients:
A retrospectively active search was carried out in the radiologic and clinical databases of Ribeirão Preto University Hospital, a regional reference Hospital for 1.000.000 inhabitants, from January 2001 to September 2009, looking for diffuse HCCs, based on imaging criteria. Twenty-six out of 180 patients with diagnosed HCC (14.4%) met the criteria for diffuse-type HCC (21 men (80.7%) and 5 women (19.3%); mean age of 55 +/- 11.8 years, ranging from 18 to 72 years).
Imaging criteria – modified from Kanematsu et al [3]:
1) no distinct margination on any portion of the tumor;
2) permeative appearance;
3) patchy or miliary enhancement corresponding to the tumors on the early-phase postcontrast CT and/or MR images (fig. 1).
Additional criteria:
- Neoplasic portal venous thrombosis characterized by expansive intra-portal mass with early-phase postcontrast enhancement with no visualization of well-defined hepatic mass lesion (fig. 2,3).
- Small infiltrative diffuse-type HCC were characterized when the imaging findings were restrict to a hepatic segment only (fig. 4).