Malignant Tumors Misdiagnosed as Liver Hemangiomas

Abstract

Background and Aim: To derive lessons from the data of patients who were followed for various periods with the misdiagnosis of liver hemangioma and eventually found to have a malignancy.Material and Methods: The records of 23 patients treated between 2003 and 2018 were analyzed retrospectively.Results: Twelve patients were men and 11 were women; median (range) age was 55 (35–80). The principal diagnostic modality for the initial diagnosis was ultrasonography (n:8), magnetic resonance imaging (MRI) (n:13), and computed tomography (CT) (n:2). At our institution, MRI was performed in 16 patients; the diagnosis was made with the available MRI and CT studies in five and two patients, respectively. In other words, the ultrasonography interpretations were not confirmed on MRI; in others, the MRI or CT examinations were of low quality or they had not been interpreted properly. Fifteen patients underwent surgery; the other patients received chemotherapy (n:6) or chemoembolization (n:2). The misdiagnosis caused a median (range) 10 (0–96) months delay in treatment. The final diagnoses were hepatocellular carcinoma in 12 patients, cholangiocarcinoma in four patients, metastatic mesenchymal tumor, metastasis of colon cancer, metastatic neuroendocrine carcinoma, sarcomatoid hepatocellular carcinoma, angiosarcoma, thoracic wall tumor, and metastatic tumor of unknown primary in one patient each.Conclusions: High-quality MRI with proper interpretation and judicious follow up are vital for the accurate differential diagnosis of liver lesions.

Magnetic resonance imaging features varying by size in giant hemangioma of the liver

“…In another study, the ADC value in the differential diagnosis was found to be 2.30×10-3mm2/ and it was reported to have 55% sensitivity and 100% specificity [16]. In the study by Hardie et al, hepatic hemangiomas and metastatic lesions of the liver were compared and the mean ADC value of hemangiomas was found to be significantly higher than metastatic lesions [17]. Differential diagnosis for giant hemangiomas can always involve difficulties.…”

Системна хiмiотерапiя при нерезектабельнiй формi внутрiшньопечiнкової саркоматоїдної холангiокарциноми: клiнiчний випадок та огляд лiтератури

“…Саркоматоїдна внутрiшньопечiнкова холангiокарцинома (сВХК) є надзвичайно рiдкiсним пiдтипом ВХК, що за класифiкацiєю Всесвiтньої органiзацiї охорони здоров'я визначений як рак бiлiарного тракту (РБТ), морфологiчно подiбний до веретеноклiтинної саркоми, фiбросаркоми або злоякiсної фiброзної гiстiоцитоми, i характеризується саркоматоїдними змiнами рiзного ступеня вираженостi у пухлинi епiтелiального походження [1]. Цей тип пухлини зустрiчається в 2-4,5 % осіб з ВХК [2] та є складним з точ-ки зору дiагностики через те, що не має специфiчних лабораторних i радiологiчних ознак та може iмiтувати iншi вогнищевi ураження печiнки, такi, наприклад, як абсцес печiнки [3] або гемангiома печiнки [4]. Основною опцiєю лiкування сВХК є хiрургiчне видалення.…”