Radiological diagnosis of hepatocellular carcinoma in non-cirrhotic patients

Castan, Alba; Navarro, Ylenia; Sarría, Luis; Larrosa, Raquel; Serradilla, M.; Serrablo, Alejandro

doi:10.20517/2394-5079.2015.62

Cited by 10 publications

(11 citation statements)

References 24 publications

(24 reference statements)

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“…HCC in non-cirrhotic patients is clinically silent in its early stages because of lack of symptoms and surveillance imaging; and higher hepatic reserve in this population[82]. The median age of these patients is 69 yr however, the FLC variant commonly occurs in adolescents and young adults, ranging from 10-35 yr at presentation[11,16].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Other symptoms include abdominal distention, weight loss, malaise, anorexia, fatigue, chronic diarrhea, jaundice, chest pain and fever of unknown origin[4,83,84]. Non-cirrhotic HCC can also present in the form of paraneoplastic syndrome of hypercalcemia or hypoglycemia[82,85]. FLC has been known to present with gynecomastia, recurrent deep vein thrombosis, Budd-Chiari syndrome, non-bacterial thrombotic endocarditis, fulminant liver failure or encephalopathy[10].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…The appearance of HCC on US is variable and non-specific ranging from hypo or hyperechoic lesions with or without heterogeneity or necrotic areas. This imaging modality is limited in the detection of tumors < 2 cm and tumors in a liver base with a heterogeneous diffuse nodular pattern[82,84].…”

Section: Diagnosismentioning

confidence: 99%

“…Contrast-enhanced US (CEUS) could be valuable diagnostic tool because the dye allows its use in patients with nephropathies and those with known adverse reactions to other contrast agents[82]. CEUS shows a typical HCC vascular pattern, although inconsistently when compared to computed tomography (CT) and magnetic resonance imaging (MRI) especially for tumors < 2 cm[96-99].…”

Section: Diagnosismentioning

confidence: 99%

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Hepatocellular carcinoma in non-cirrhotic liver: A comprehensive review

Desai

Sandhu

Lai

et al. 2019

WJH

237

203

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Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, which in turns accounts for the sixth most common cancer worldwide. Despite being the 6th most common cancer it is the second leading cause of cancer related deaths. HCC typically arises in the background of cirrhosis, however, about 20% of cases can develop in a non-cirrhotic liver. This particular subgroup of HCC generally presents at an advanced stage as surveillance is not performed in a non-cirrhotic liver. HCC in non-cirrhotic patients is clinically silent in its early stages because of lack of symptoms and surveillance imaging; and higher hepatic reserve in this population. Interestingly, F3 fibrosis in non-alcoholic fatty liver disease, hepatitis B virus and hepatitis C virus infections are associated with high risk of developing HCC. Even though considerable progress has been made in the management of this entity, there is a dire need for implementation of surveillance strategies in the patient population at risk, to decrease the disease burden at presentation and improve the prognosis of these patients. This comprehensive review details the epidemiology, risk factors, clinical features, diagnosis and management of HCC in non-cirrhotic patients and provides future directions for research.

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Section: Clinical Featuresmentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

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Hepatocellular carcinoma in non-cirrhotic liver: A comprehensive review

Desai

Sandhu

Lai

et al. 2019

WJH

237

203

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“…In our study, USS only accounts for 16% as a primary imaging modality. It is a good diagnostic and surveillance tool; however, the main limitation of USS is the detection of small tumours (<2 cm) . Other variables such as lesion location, body habitus and sonographic technical factors have to be accounted for and most indeterminate lesions larger than 5 mm on CT can be detected and characterized on hepatic sonography …”

Section: Discussionmentioning

confidence: 99%

Indeterminate liver lesions – a virtual epidemic: a cohort study over 8 years

Kuan

Mavilakandy

Oyebola

et al. 2020

ANZ Journal of Surgery

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Background: Within the last decade, advances and availability in radiological imaging have led to an increase in the detection of incidental liver lesions (ILLs) in the asymptomatic patient population. This poses a diagnostic conundrum. This study was undertaken to review the outcome of liver lesions labelled as 'indeterminate' in asymptomatic patients without a biopsy-proven concomitant primary tumour. The secondary aim was to assess the impact on healthcare resources and cost-effectiveness with regards to the frequency and modality of radiological scans, multidisciplinary team discussions and clinic reviews. Methods: The study consisted of a retrospective analysis of prospectively collected data from the University Hospitals of Leicester multidisciplinary team database. The study period ranged from 2010 to 2015. All patients were followed-up for 3 years to ensure no late re-occurrences with malignancy. Results: A total of 92 patients with ILL were identified. The median age was 72 years. The median size of these ILLs was 10 mm. Eighty-seven patients required supplementary imaging and 42 required a third imaging. Ninety-one patients had benign lesions. Only one case was biopsy proven to be malignant. Conclusion: Small (<15 mm) hepatic lesions discovered incidentally in patients with no known primary malignancy and risk factors are virtually always benign, with a 1% risk of malignancy. There is a need for a classification system, which stratifies ILLs by malignant potential based on a standardized and evidence-based approach. This is important to prevent unnecessary investigations. A multidisciplinary approach in an experienced hepatobiliary and pancreatic centre is recommended until such a classification exists.© 2020 Royal Australasian College of Surgeons ANZ J Surg 90 (2020) 791-795

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