Small Hepatocellular Carcinoma—A Clinicopathological Study in Thirteen Patients

From December 1964 to November 1989, 71 children from 3 to 17 years of age with the eventual diagnosis of hepatocellular carcinoma (HCC) presented at the National Taiwan University Hospital (Taipei, Taiwan, Republic of China). Forty‐three of them had pathologic proof, whereas 28 were diagnosed on a clinical and laboratory basis. A male predominance (M:F = 3.2:1) was noticed. Most patients presented in a late, advanced stage. Abdominal pain and abdominal mass were the major symptoms and signs, followed by anorexia, fever, and internal bleeding. Hydrocele, purpura, and obstructive jaundice were rare presenting symptoms. Hepatosplenomegaly, superficial venous engorgement, and ascites were the main physical signs. The prognosis for such children with HCC was very poor. Only 10% of the patients survived longer than 1 year after the onset of the initial symptom. Among 49 patients who could be followed, only two had long‐term survival of over 5 years. One patient had a small HCC with internal bleeding, whereas the other had a large HCC with abdominal distention. Both received surgical resection, and a resection was repeated for tumor recurrence in the patient with the large mass. The resectability of these 71 patients was low (9.8%). Resectability and nonicterus seemed to be the factors indicating favorable prognosis. Observation indicated that the prognosis for children with symptomatic HCC is grave but surgical resection, whenever possible, should be carried out.

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“…1). The male-to-female ratio was 3.2:l (M:F = 54: 17). Forty-nine patients were followed and outcome doc- charge from the hospital.…”

Section: Methodsmentioning

confidence: 99%

Hepatocellular carcinoma in childhood. Clinical manifestations and prognosis

Chang

Hsu

et al. 1991

Cancer

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“…1 The reported sensitivity of ultrasonography in detecting HCC in cirrhotic liver on the basis of explanted liver for transplantation varied from 42% to 96%. [2][3][4][5][6] However, to our knowledge there has been no study of the true detectability of dysplastic nodules (DNs) by ultrasonography in patients with liver cirrhosis. Using explanted liver as a standard of reference, we prospectively evaluated the sensitivity and specificity of ultrasonography for the detection of HCCs and DNs in patients with liver cirrhosis.…”

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confidence: 99%

Detection of hepatocellular carcinomas and dysplastic nodules in cirrhotic liver: accuracy of ultrasonography in transplant patients.

Kim

Lim

Lee

2001

J of Ultrasound Medicine

138

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The purpose of this study was to assess the usefulness of ultrasonography in the detection of hepatocellular carcinomas and dysplastic nodules in patients with liver cirrhosis. Pretransplantation sonograms in 52 patients with liver cirrhosis who underwent orthotopic liver transplantation were evaluated retrospectively. The numbers of hepatocellular carcinomas and dysplastic nodules were assessed in the explanted liver specimens and compared with pretransplantation ultrasonographic results. Eighteen hepatocellular carcinomas in 16 patients and 20 dysplastic nodules in 11 patients were present in the explanted livers. The size of hepatocellular carcinomas ranged from 0.6 to 5.0 cm (mean, 2.1 cm) in diameter, and that of dysplastic nodules ranged from 0.5 to 1.7 cm (mean, 1.0 cm) in diameter. Pretransplantation ultrasonography enabled detection of 6 of 18 hepatocellular carcinoma and 0 of 20 dysplastic nodule lesions; lesion detection sensitivity for hepatocellular carcinomas and dysplastic nodules was 33% and 0%, respectively. Patient sensitivity and specificity for hepatocellular carcinomas were 38% (6 of 16) and 92% (33 of 36), and those for dysplastic nodules were 0% and 95% (39 of 41), respectively. On the basis of our results, ultrasonography is insensitive for detection of hepatocellular carcinomas and dysplastic nodules in patients with advanced liver cirrhosis.

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“…Researchers investigating the accuracy of CT and ultrasonography for detection of hepatocellular carcinoma in cirrhotic patients have reported a wide range of accuracies. [3][4][5][6][7][8][9][10][11] The reported sensitivity of CT in detecting hepatocellular carcinoma in cirrhotic patients has ranged from 59% to 94%.4,7,11 Similarly, the reported sensitivity of ultrasonography has HEPATOCELLULAR CARCJNOMA varied from 42% to 95%.5.11 Relatively few studies have compared the sensitivity of CT and ultrasonography directly and correlated their findings with pathologic results from total hepatectomy specimens.4 To further investigate these issues, we conducted a study comparing the sensitivity of CT and ultrasonography for the detection of hepatocellular carcinoma in patients with cirrhosis.…”

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confidence: 99%

Detection of hepatocellular carcinoma in cirrhotic patients: sensitivity of CT and ultrasonography.

Shapiro

Katz

Mendelson

et al. 1996

Journal of Ultrasound in Medicine

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Patients with cirrhosis are at increased risk for the development of hepatocellular carcinoma. The heterogeneous hepatic parenchyma produced by cirrhosis makes detection of hepatomas more difficult. The purpose of this study was to determine the sensitivities of CT and ultrasonography for detecting hepatomas in cirrhotic patients. A retrospective analysis was performed of 733 patients who underwent liver transplantation at our institution. A study population of 21 patients was selected who met our inclusion criteria. The inclusion criteria required a pathologic diagnosis of hepatocellular carcinoma, pathologic evidence of cirrhosis, and contrast-enhanced CT and sonographic examinations performed within 1 week of each other. The sensitivities of CT and ultrasonography were determined by comparing the imaging findings with pathology findings from serially sectioned total hepatectomy specimens. A total of 40 hepatomas were detected pathologically in the 21 patients in our study population. CT identified 12 of 21 patients with hepatomas and detected 18 of 40 individual lesions (patient detection sensitivity = 57%, lesion detection sensitivity = 45%). Ultrasonography identified 14 of 21 patients with hepatomas and detected 21 of 40 individual lesions (patient detection sensitivity = 67%, lesion detection sensitivity = 51%). Combining the findings of CT and ultrasonography allowed identification of 17 of 21 patients with hepatomas and detection of 24 of 40 individual lesions (patient detection sensitivity = 80%, lesion detection sensitivity = 60%). We conclude that CT and ultrasonography have a low sensitivity for the detection of hepatocellular carcinoma in patients with cirrhosis.

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Small Hepatocellular Carcinoma—A Clinicopathological Study in Thirteen Patients

Cited by 121 publications

References 11 publications

Hepatocellular carcinoma in childhood. Clinical manifestations and prognosis

Hepatocellular carcinoma in childhood. Clinical manifestations and prognosis

Detection of hepatocellular carcinomas and dysplastic nodules in cirrhotic liver: accuracy of ultrasonography in transplant patients.

Detection of hepatocellular carcinoma in cirrhotic patients: sensitivity of CT and ultrasonography.

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