Imaging features of ultrasound and contrast-enhanced ultrasound in primary hepatic carcinosarcoma: three cases report

Liu, Chunrui; Wei, Shuping; Wu, Min; Kong, Wencheng

doi:10.11152/mu-2002

Cited by 4 publications

(7 citation statements)

References 11 publications

(14 reference statements)

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“…1. This is consistent with previous ndings that hyperechoic calci cation may be the classic sign of HCS [22] . On CEUS, HSC displayed peripheral nodular heterogeneous hyperintensity or hypointensity in the AP, and hypo-enhancing in the portal phase and in the late phase.…”

Section: Discussionsupporting

confidence: 94%

“…Sensitive depiction of arterial hypervascularity and analysis of washout pattern are clues for differentiation of several indeterminate hepatic nodules on conventional US, CT and MRI [20]. However, the CT and MRI manifestations of HSC and HS have been investigated in former case reports, but the US, CEUS and contrast-enhanced CT (CECT) features, particularly the differentiations between the two tumors, are seldom reported [21][22][23][24] . Although there are frequent overlaps in the US, CEUS, and CECT appearances between these two rare malignant tumors, some characteristic imaging features can contribute to the diagnosis [25] .…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonography, contrast-enhanced ultrasonography and contrast- enhanced computer tomography features of hepatic sarcomatoid carcinoma and hepatic sarcoma: a retrospective study of 23 cases

Long,

Wu,

Liu

et al. 2024

Preprint

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Background Hepatic sarcomatoid carcinoma (HSC) and hepatic sarcoma (HS) are rare malignancies. Without pathology, the differential diagnosis between these two tumors are difficult due to their frequent overlaps in clinical presentations and imaging features. Currently, there are limited analyses about the ultrasound (US), contrast-enhanced ultrasound (CEUS) and contrast-enhanced computer tomography (CECT) characteristics of HSC and HS. Therefore, the purpose of our study is to evaluate the value of US, CEUS and CECT on the differential diagnosis between HSC and HS. Methods From 2015 to 2022, a total of 23 patients with HSC (n = 11) and HS (n = 12) are included in this retrospective study. We analyze the clinical, pathological, and imaging data of these patients. Analysis of differences is performed to determine the consistent and distinctive features. Results HSCs have a considerably higher prevalence of chronic hepatitis (p = 0.005) and cirrhosis (P = 0.027) than HSs, while metastases are more prevalent in HSs (P = 0.005). The lesion size of HSCs (8.1 ± 2.2 cm) is slightly larger than that of HSs (6.2 ± 3.4 cm). On conventional US, the characteristics of HS and HSC are similar. On CEUS, HSC can be differentiated from HS by heterogeneous rim-like enhancement with necrotic zone during arterial phase (AP). Notably, for different pathological types of HS, the presence of enhancement in AP on CECT can be used to distinguish hepatic fibrosarcoma from hepatic liposarcoma. Conclusion HSC and HS generally present as masses with hypo-echoic and hypo-vascularity. HSC usually presents heterogeneous density. The degree of enhancement, the time of wash-out start, and the presence of necrotic areas may contribute to distinguish the different pathological types of HS.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Ultrasonography, contrast-enhanced ultrasonography and contrast- enhanced computer tomography features of hepatic sarcomatoid carcinoma and hepatic sarcoma: a retrospective study of 23 cases

Long,

Wu,

Liu

et al. 2024

Preprint

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“…Contrast-enhanced ultrasound detects a thicker ring-enhancing part of the abscess than that of PLSC patients, 39 peripheral nodular enhancement of PLSC, and hypervascularization of HCC in the arterial phase. 31 , 40 However, these differences are minor and difficult to practice, so difficulties in diagnoses should always be considered.…”

Section: Discussionmentioning

confidence: 99%

“…For patients suffering from advanced PLSC at initial diagnosis and with recurrence after surgery, the prognosis is worse, with a median OS of less than 6 months. 43 Cytotoxicity drugs and sorafenib 44,45 have been used for treatments, including gemcitabine combined with paclitaxel, 35 gemcitabine combined with cisplatin, 40 and pirarubicin combined with cisplatin, 46 but only in case reports. Epirubicin combined with cisplatin (Case 4) and docetaxel combined with cisplatin (Case 9) have been used in two of our cases, but unplanned terminations made it impossible to provide information about the treatment-related prognoses.…”

Section: Dovepressmentioning

confidence: 99%

Primary Liver Sarcomatoid Carcinoma: A Case Series and Literature Review

Xing

et al. 2021

JHC

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Background: Primary liver sarcomatoid carcinoma (PLSC) is rare. To improve the understanding of PLSC, cases were described and reviewing the literature. Methods: A retrospective analysis was performed on 14 cases of PLSC diagnosed by pathology in Northeastern China from 2010 to 2020. An individual participant data analysis based on reported cases was conducted to determine epidemiological characteristics, clinical characteristics, and prognoses of PLSC. Results: A total of 136 cases involved our 14 cases and 122 cases from previous reports. The percentages of sarcomatoid hepatocellular carcinoma, sarcomatoid cholangiolocellular carcinoma, and mixed and unclassified types were 36.8%, 41.9%, 5.9%, and 15.4%, respectively. A total of 95.6% PLSC was found in Asia. There was a lower percentage of hepatitisinfected patients in Japan, when compared with the Republic of Korea (38.5% vs 70.0%, P<0.05). Five cases were initially misdiagnosed as a hepatic abscess by imaging. A total of 36.7% cases had metastases when being diagnosed, and 68.9% cases relapsed during the follow-up. The median disease-free survival and overall survival (OS) were 3 months and 5 months, respectively. Only radical surgery (hazard ratio = 0.308, 95% confidence interval 0.186-0.512, P<0.001) indicated a better OS. Conclusion: PLSC was more prevalent in Asia and there were possibilities of misdiagnoses. Surgery is still an effective treatment and can significantly prolong the OS. Only limited strategies for recurrent or advanced PLSC, immunotherapy may be possible treatment.

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“…In the retrospective literature, 24 articles 2,3,[7][8][9][10][11]13,14,17,[19][20][21][22][23][24][26][27][28][29][30][31][32][33] were involved in the imaging manifestations, including our study of total of 35 patients. Due to the different proportion of carcinomatous components and sarcomatous components in HCS, and their pathological types were not the same, the imaging manifestations were different.…”

Section: Discussionmentioning

confidence: 99%

<p>The Clinicopathological and Imaging Characteristics of Primary Hepatic Carcinosarcoma and a Review of the Literature</p>

Bin

Chen

Peng

et al. 2020

JHC

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Purpose: To improve the understanding of hepatic carcinosarcoma (HCS) by analyzing radiological imaging data and clinicopathological features. Materials and Methods: A retrospective analysis was performed on four patients with HCS confirmed immunohistochemically. The analysis included three males and one female, aged 29 to 64 years. Four patients underwent computed tomography (CT) scans, and one underwent magnetic resonance imaging (MRI) scans simultaneously. Results: Three patients had a history of hepatitis B, cirrhosis or fibrosis, and two patients had schistosomiasis. Two cases tested positive for elevated serum carbohydrate antigen (CA) 19-9. The maximum diameters of the lesions ranged from 7.8 to 9.0cm. Pathologically, the carcinomatous and sarcomatous elements in two patients could not be classified, one of the patients had cholangiocellular carcinoma (CCC) and undifferentiated sarcoma, the other had hepatocellular carcinoma (HCC) and undifferentiated pleomorphic sarcoma (UPS). All tumors showed heterogeneous density/intensity, accompanied by vast cystic changes and necrosis, with two cases having cystic septations. Capsule formation was not identified. The margins of the radiological images showed irregular ring enhancement. One case presented continuous progressive enhancement, one case with "fast in fast washout" and two cases with "fast in late washout". Lymphonodus metastasis, satellite nodules, vascular embolism, and organ invasion (hepatic flexure of the colon) were identified. Conclusion: HCS is a rare, high-grade malignancy with poor prognosis. The preoperative diagnosis is expected to improve by carefully analyzing the imaging features of the patients in combination with their clinical characteristics. Radical resection and postoperative chemoradiotherapy can improve the survival rate of patients.

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Imaging features of ultrasound and contrast-enhanced ultrasound in primary hepatic carcinosarcoma: three cases report

Cited by 4 publications

References 11 publications

Ultrasonography, contrast-enhanced ultrasonography and contrast- enhanced computer tomography features of hepatic sarcomatoid carcinoma and hepatic sarcoma: a retrospective study of 23 cases

Ultrasonography, contrast-enhanced ultrasonography and contrast- enhanced computer tomography features of hepatic sarcomatoid carcinoma and hepatic sarcoma: a retrospective study of 23 cases

Primary Liver Sarcomatoid Carcinoma: A Case Series and Literature Review

<p>The Clinicopathological and Imaging Characteristics of Primary Hepatic Carcinosarcoma and a Review of the Literature</p>

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