Clinical features of hepatocellular carcinoma with extrahepatic metastases

Natsuizaka, Mitsuteru; Omura, Tomohiro; Akaike, Toru; Kuwata, Yasuaki; Yamazaki, Katsu; Sato, Takahiro; Karino, Yoshiyasu; Toyota, Jouji; Suga, Toshihiro; Asaka, Masahiro

doi:10.1111/j.1440-1746.2005.03919.x

Cited by 458 publications

(485 citation statements)

References 14 publications

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“…The incidence of HCC is increasing in countries where hepatitis B or C virus is endemic [6]. The present study enrolled a relatively large number of patients with bone metastases from HCC and showed better detectability of FDG PET/CT than bone scintigraphy.…”

Section: Discussionmentioning

confidence: 69%

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Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using 18F-FDG PET/CT and 99mTc-HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation

Seo

Choi

Kim

et al. 2011

Nucl Med Mol Imaging

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Purpose Bone metastasis from hepatocellular carcinoma (HCC) can present with soft tissue formation, resulting in oncologic emergency. Contrast-enhanced FDG PET/CT and bone scintigraphy were compared to evaluate characteristics of bone metastases with or without soft tissue formation from HCC. Methods Of 4,151 patients with HCC, 263 patients had bone metastases. Eighty-five patients with bone metastasis from HCC underwent contrast-enhanced FDG PET/CT. Fifty-four of the enrolled subjects had recent 99m Tc-HDP bone scintigraphy available for comparison. Metastatic bone lesions were identified with visual inspection on FDG PET/CT, and maximum standardized uptake value (SUV max ) was used for the quantitative analysis. Confirmation of bone metastasis was based on histopathology, combined imaging modalities, or serial follow-up studies. Results Forty-seven patients (55%) presented with soft tissue formation, while the remaining 38 patients presented without soft tissue formation. Frequent sites of bone metastases from HCC were the spine (39%), pelvis (19%), and rib cage (14%). The soft-tissue-formation group had more frequent bone pain (77 vs. 37%, p<0.0001), higher SUV max (6.02 vs. 3.52, p<0.007), and higher incidence of photon defect in bone scintigraphy (75 vs. 0%) compared to the non-soft-tissue-formation group. FDG PET/CT had higher detection rate for bone metastasis than bone scintigraphy both in lesion-based analysis (98 vs. 53%, p=0.0015) and in patient-based analysis (100 vs. 80%, p<0 .001). Conclusions Bone metastasis from HCC showed a high incidence of soft tissue formation requiring emergency treatment. Although the characteristic findings for soft tissue formation such as photon defect in bone scintigraphy are helpful in detection, overall detectability of bone metastasis is higher in FDG PET/CT. Contrast-enhanced PET/CT will be useful in finding and delineating softtissue-forming bone metastasis from HCC.

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Section: Discussionmentioning

confidence: 69%

“…Bone metastasis from HCC is not uncommon, and the incidence has been increasing [5,6]. A recent study reported that patients with isolated bone metastasis showed longer survival than those with metastases in bone and other sites [7].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using 18F-FDG PET/CT and 99mTc-HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation

Seo

Choi

Kim

et al. 2011

Nucl Med Mol Imaging

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“…Uka et al stated that extrahepatic metastases from HCC most commonly occur in the lungs (47%), lymph nodes (45%), bones (37%), and adrenal glands (12%) [1] , while Natsuizaka et al reported that they tend to arise in the lungs (53.8%), bones (38.5%), lymph nodes (33.8%), and adrenal glands (16.9%) [2] . In addition, Jung et al found that most metastases occurred in the lungs (55%), lymph nodes (46.7%), bones (20.4%), and adrenal glands (7.5%) [3] .…”

Section: Discussionmentioning

confidence: 99%

“…Extrahepatic metastases in patients with HCC are becoming more common due to improved diagnostic methods and prolonged survival [ incidence of extrahepatic metastases in HCC patients is 15.2% and 13.5%, respectively [1,2] . Uka et al stated that extrahepatic metastases from HCC most commonly occur in the lungs (47%), lymph nodes (45%), bones (37%), and adrenal glands (12%) [1] , while Natsuizaka et al reported that they tend to arise in the lungs (53.8%), bones (38.5%), lymph nodes (33.8%), and adrenal glands (16.9%) [2] .…”

Section: Discussionmentioning

confidence: 99%

“…HCC treatment has advanced markedly over the past 40 years, and the prognosis of HCC has significantly improved due to the development of various diagnostic imaging techniques and treatments. However, the prognosis of patients with extrahepatic metastasis from advanced HCC continues to be extremely poor [1][2][3][4] , with the median survival time of such patients being 4.9 months [1] . Here, we report a rare case of HCC involving a patient who survived for 12 years after multidisciplinary treatment (which did not include surgery), even though he developed recurrent HCC and right adrenal and lymph node metastases.…”

Section: Introductionmentioning

confidence: 99%

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Hepatocellular Carcinoma with Recurrent Extrahepatic Metastases: A Case of Longterm Survival

Nakanowatari

2016

Journal of Gastroenterology and Hepatology Research

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A 61-year-old man had been followed-up for chronic hepatitis since 1982. In 1995, he was diagnosed with primary hepatocellular carcinoma (HCC) and liver cirrhosis and was admitted to our hospital with a Child-Pugh score of 6 (class A). A right hepatic arteriogram revealed two tumors: one measured 23 × 21 mm in size and was located in segment 6 of the liver, while the other measured 16 × 14 mm in size and was located in segment 4. The tumors were treated with transarterial chemoembolization (TACE) and percutaneous ethanol injection (PEI). In 1996, a new HCC in segment 8, a recurrent HCC in segment 4, and a right adrenal metastasis were detected, all of which were treated with TACE. In 1997, the right adrenal metastasis recurred, and TACE was performed again. In 1999, TACE was used to treat metastases in a lymph node along the lesser curvature of the stomach and a lymph node along the left gastric artery. In 2002, a recurrent metastatic lesion developed in the lymph node along the lesser curvature of the stomach and was subjected to TACE. In 2005, a recurrent HCC lesion, measuring 18 mm in diameter, was detected in segment 4, and radiofrequency ablation (RFA) was performed. The patient experienced repeated HCC recurrences, as well as adrenal and lymph node metastases, but received multidisciplinary treatment, including TACE, PEI, and RFA, and survived for 12 years.

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Hepatocellular Carcinoma

Singal¹,

Marrero²

2015

Yamada' S Textbook of Gastroenterology

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Clinical features of hepatocellular carcinoma with extrahepatic metastases

Cited by 458 publications

References 14 publications

Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using 18F-FDG PET/CT and 99mTc-HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation

Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using 18F-FDG PET/CT and 99mTc-HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation

Hepatocellular Carcinoma with Recurrent Extrahepatic Metastases: A Case of Longterm Survival

Hepatocellular Carcinoma

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