Hepatocellular carcinoma

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[edit] Discussion

  • Hepatocellular carcinoma (HCC) is the most common primary malignant hepatic neoplasm.
  • Underlying cirrhosis from alcoholism, hepatitis (B and C), and toxin exposure are the predominant causal factors.
  • The serum alpha-fetoprotein level is usually elevated in patients with HCC.

[edit] Imaging Findings

[edit] MRI

  • On T1-weighted MR images, HCC is most often hypointense relative to the liver, although hyperintense lesions or areas of hyperintensity within hypointense lesions may be seen.
    • These hyperintense regions within the HCC reflect the presence of fat, copper, protein, or blood secondary to intralesional hemorrhage.
  • On T2-weighted images, HCC is generally hyperintense, although well-differentiated lesions that are isointense relative to the liver parenchyma may be seen.
  • Most HCCs show intense enhancement on arterial phase contrast-enhanced images.
  • A large HCC (>5 cm) may have a number of characteristic features, such as a mosaic pattern, a tumor capsule, extracapsular extension with formation of satellite nodules, vascular invasion, and extrahepatic dissemination, including lymph node and distant metastases.
    • The mosaic pattern is created by confluent small nodules separated by thin septa and necrotic areas within the tumor. This pattern is more often depicted on T2-weighted MR images than on T1-weighted images.

[edit] Images

Patient #1

[edit] See Also

[edit] External Links

[edit] References