Type:
Educational Exhibit
Keywords:
Pathology, Neoplasia, Surgery, Biopsy, MR, CT, Oncology, Liver, Abdomen
Authors:
S. Bivol1, C. E. Balasa1, N. Leo2, C. Guettier1, P. Bucur2, A. Elmaleh2, Z. Dhina-Louison3, H. Lemaissi4, M. Lewin2; 1Paris/FR, 2Villejuif/FR, 3Vincennes/FR, 4Bretigny/Orge/FR
DOI:
10.1594/ecr2013/C-1764
Conclusion
Final diagnosis of HEH requires a tumor biopsy,
followed by histopathologic findings.The prognosis depends on whether extrahepatic metastases are present at the time of diagnosis.
Extrahepatic involvement includes the peritoneal lymph nodes,
omentum and mesentery and may be associated with calcification.
Thoracic disease (intrapulmonary or pleural),
cutaneous or intramuscular metastases may be observed in some cases. (Fig. 15)
In the absence of extrahepatic disease,
radical resection is an option,
liver transplantation being considered the best option if metastatic desease.
Some imaging findings are highly characteristic for HEH and need to be remembered: predominant distribution at the periphery of the liver,
intratumoral calcifications,
changes of the liver contour (capsular retraction and compensatory hypertrophy of the normal liver),
invasion of portal and hepatic veins ("lollipop sign"),
tumors composed of concentric zones ("target sign"),
changes of nodular lesions to large coalescent masses.