Hepatocellular carcinoma in otherwise sonographically normal liver

Abstract

Purpose Hepatocellular carcinoma (HCC) on normal liver is very rare. The goal of this study was to determine the clinical manifestations and the role of ultrasonography (US) in the diagnosis of HCC arising in normal liver. Methods The clinical data and US findings in 12 cases of surgically resected HCC in normal liver were retrospectively analyzed. Results The patients were asymptomatic, had no hepatocarcinogenic factor, and hepatic function tests were almost normal in most cases. HCCs were large, encapsulated, and solitary, and there were predominantly well‐differentiated or moderately differentiated in most cases. US showed a hypoechoic rim and lateral shadowing, suggestive of peritumoral capsule formation, and on contrast‐enhanced US (CEUS), the tumor was hyperenhanced in arterial phase and washed out in postvascular phase, revealing typical HCC findings. Conclusions US raises suspicion of HCC by showing lateral shadowing on grayscale ultrasound and hypervascularity on CEUS of the lesion.

Management of Acute Coronary Syndrome With a Bleeding Intra-Tumoral Hepatocellular Carcinoma: A Case Report

“…There was an absence of any abdominal pain, melena, vomiting, weight loss, irregular bowel bladder habits, or any underlying known chronic liver disease even in its stage of nodal metastasis, making it difficult to diagnose. The liver showed a normal function and architecture, with no evidence of cirrhosis on imaging, which has been rare [ 15 ]. Another incidental finding observed, was that of a hydatid cyst.…”

Diagnosis and Resection Treatment of Triplet Hepatocellular Carcinomas with a non-B non-C Background in a Middle Aged Man over a Period of 6-years

“…The histopathological findings of all three tumors were moderately differentiated HCCs with non-B non-C chronic liver damage and mild fibrosis. While several studies of HCC with a background of non-B non-C chronic liver damage and normal or mild fibrotic liver have been reported (5)(6)(7)(8), triple hepatocarcinogenesis is rare. In our patient, all three of the tumors were solitary, measuring !…”

“…The development of HCC correlates with the progression of liver fibrosis, and the rate of future carcinogenesis is predicted by the degree of fibrosis (3,4). HCC is rare in subjects with normal or mild fibrosis of the liver (5)(6)(7)(8). We herein report triplet HCCs, diagnosed at ages 65, 67 and 71 years in a patient with non-B non-C liver injury and mild fibrosis.…”

Letter to the Editor on “Strategy for Accurate Diagnosis by Contrast‐Enhanced Ultrasound of Focal Liver Lesions in Patients Not at High Risk for Hepatocellular Carcinoma”

“…Furthermore, according to the literature, HCC on non-fibrotic liver are asymptomatic, negative hepatitis viral infection, and show no abnormalities in hepatic function or tumor markers. 4 Thus, we want to know if the HCC case in the low risk group shows arterial hyperenhancement with washout, as is seen in other HCCs in the intermediate group. 4.…”