No abstract available.
Carcinoma, Hepatocellular/*diagnosis/pathology ; Cholangiocarcinoma/*diagnosis/pathology ; Humans ; Liver Neoplasms/*diagnosis/pathology/radiography ; Male ; Middle Aged ; Neoplasms, Multiple Primary/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed

Primary hepatic carcinosarcoma which has comprised of a mixture of both carcinomatous and sarcomatous elements is very rare. This tumor has been variously called as carcinosarcoma, pleomorphic large cell carcinoma, giant cell carcinoma, or undifferentiated carcinoma. Only less than 20 cases of carcinosarcoma of the liver have been reported sporadically up to now worldwide. Herein, we present a case of carcinosarcoma of the liver along with a review of the literatures.
Aged ; Carcinosarcoma/*diagnosis/pathology/radiography ; Female ; Humans ; Liver Neoplasms/*diagnosis/pathology/radiography ; Mastectomy, Segmental ; Tomography, X-Ray Computed ; Vimentin/metabolism

Hepatocellular carcinoma (HCC) rarely invades the gastrointestinal (GI) tract. It occurs in 0.7% to 2% of clinical HCC cases. Moreover, gastric invasion with GI hemorrhage via peritoneal seeding is very rare. We report the case of 67-year-old woman who had a history of HCC rupture and was admitted due to left upper quadrant abdominal pain. The patient was diagnosed with three omental metastatic masses and underwent hepatic segmentectomy and omental tumorectomy. Two months later, the patient had massive melena, and an esophagogastroduodenoscopy showed very large ulcerated friable mass on the gastric body. The histology was consistent with the diagnosis of metastatic HCC. The patient died from persistent GI hemorrhage 93 days after the admission. This case illustrates the very rare event of peritoneal seeding of a ruptured HCC causing direct invasion of the stomach, followed by GI hemorrhage.
Aged ; Carcinoma, Hepatocellular/*diagnosis/radiography/secondary ; Female ; Gastrointestinal Hemorrhage/*diagnosis/etiology/radiography ; Gastroscopy ; Humans ; Liver Neoplasms/*diagnosis/pathology/radiography ; *Neoplasm Seeding ; Peritoneal Neoplasms/*diagnosis/radiography/secondary ; Stomach Neoplasms/*diagnosis/radiography/secondary ; Tomography, X-Ray Computed

Benign hypervascular hyperplastic nodules (HHN) in liver cirrhosis are very rare. It is important to distinguish between regenerative nodules (hyperplastic nodules) and tumorous nodules (dysplastic or neoplastic nodules) in hepatocellular nodular lesions. The differential diagnosis between HHN and hepatocellular carcinoma on the basis of radiologic imaging is often difficult, and is clinically important when determining the therapeutic plan. Therefore, histological confirmation by needle biopsy sampling of the liver is necessary for a correct diagnosis of HHN. We report herein a case of benign HHN mimicking hepatocellular carcinoma in a 32-year-old male alcoholic liver cirrhosis patient without viral hepatitis infection.
Adult ; Carcinoma, Hepatocellular/diagnosis ; Humans ; Hyperplasia/diagnosis ; Liver/*pathology ; Liver Cirrhosis, Alcoholic/*diagnosis/pathology/radiography ; Liver Neoplasms/diagnosis ; Magnetic Resonance Angiography ; Male ; Tomography, X-Ray Computed

We report herein a case of hepatoid adenocarcinoma of the stomach with liver metastasis. Gastric carcinoma generally presents as adenocarcinoma and rarely shows a hepatoid pattern, which can produce alpha-fetoprotein (AFP). The stomach is one of the common sites at which hepatoid adenocarcinoma has been detected. A 75-year-old female patient was admitted to the hospital with a symptom of epigastric discomfort. Gastrofibroscopy revealed a large tumor occupying the greater curvature of the stomach body. The level of serum AFP was markedly increased. Abdominal computed tomography revealed multiple liver masses. Biopsy samples of the gastric lesion and liver masses finally confirmed her case as hepatoid adenocarcinoma in the stomach with liver metastasis. The AFP-producing gastric carcinoma needs special attention because it often presents with early liver metastasis and has a poor prognosis.
Adenocarcinoma/*diagnosis/pathology/radiography ; Aged ; Female ; Gastroscopy ; Humans ; Liver Neoplasms/*diagnosis/secondary/ultrasonography ; Lymphatic Metastasis ; Stomach Neoplasms/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed ; alpha-Fetoproteins/metabolism

Perivascular epithelioid cell tumors (PEComas) are unusual mesenchymal neoplasms composed of histologically and immunohistochemically distinct perivascular epithelioid cells (PECs). Although PEComas have the potential to behave in a malignant fashion, malignant PEComas arising from the retroperitoneum are extremely rare. A 68-year-old woman presented with a painful palpable mass in her left upper abdomen. Computed tomography of the abdomen showed a 9 cm sized heterogeneous mass in left para-aortic space and multiple hypervascular nodules in the liver. 18F-fludeoxyglucose-PET/CT showed multifocal hypermetabolic lesions in retroperitoneum, liver, and skeletal bones. Percutaneous needle biopsies were done on the retroperitoneal and hepatic mass. Both specimens were positive for human melanoma black-45 (HMB-45) on histological and immunohistochemical staining which was compatible with PEComas. Herein, we report a rare case of retroperitoneal PEComa with multiple metastases involving liver and bone at initial diagnosis that exhibited aggressive behavior and resulted in a devastating prognosis.
Aged ; Bone Neoplasms/pathology/radiography/secondary ; Female ; Fluorodeoxyglucose F18 ; Humans ; Liver Neoplasms/pathology/radiography/secondary ; Perivascular Epithelioid Cell Neoplasms/*diagnosis/pathology ; Positron-Emission Tomography ; Tomography, X-Ray Computed

OBJECTIVE: To describe computed tomography (CT) features of metastatic gallbladder (GB) tumors (MGTs) from various primary tumors and to determine whether there are differential imaging features of MGTs according to different primary tumors. MATERIALS AND METHODS: Twenty-one patients who had pathologically confirmed MGTs and underwent CT were retrospectively enrolled. Clinical findings including presenting symptoms, type of surgery, and interval between primary and metastatic tumors were recorded. Histologic features of primary tumor and MGTs including depth of invasion were also reviewed. Imaging findings were analyzed for the location and morphology of MGTs, pattern and degree of enhancement, depth of invasion, presence of intact overlying mucosa, and concordance between imaging features of primary and metastatic tumors. Significant differences between the histologies of MGTs and imaging features were determined. RESULTS: The most common primary tumor metastasized to the GB was gastric cancer (n = 8), followed by renal cell carcinoma (n = 4) and hepatocellular carcinoma (n = 3). All MGTs (n = 21) manifested as infiltrative wall thickenings (n = 15) or as polypoid lesions (n = 6) on CT, similar to the features of primary GB cancers. There were significant differences in the morphology of MGTs, enhancement pattern, enhancement degree, and depth of invasion according to the histology of primary tumors (p < 0.05). Metastatic adenocarcinomas of the GB manifested as infiltrative and persistently enhancing wall thickenings, while non-adenocarcinomatous metastases usually manifested as polypoid lesions with early wash-in and wash-out. CONCLUSION: Although CT findings of MGTs are similar to those of primary GB cancer, they are significantly different between the various histologies of primary tumors.
Adenocarcinoma/pathology/radiography/secondary ; Adult ; Aged ; Carcinoma, Hepatocellular/pathology/radiography/secondary ; Carcinoma, Renal Cell/pathology/radiography/secondary ; Carcinoma, Squamous Cell/pathology/radiography/secondary ; Diagnosis, Differential ; Female ; Gallbladder Neoplasms/pathology/*radiography/*secondary ; Humans ; Kidney Neoplasms/pathology ; Liver Neoplasms/pathology ; Male ; Melanoma/pathology/radiography/secondary ; Middle Aged ; Neoplasm Invasiveness/radiography ; Retrospective Studies ; Stomach Neoplasms/pathology ; *Tomography, X-Ray Computed

No abstract available.
Carcinoma, Hepatocellular/*diagnosis/pathology/radiography ; Hepatitis B, Chronic/diagnosis ; Humans ; Liver Neoplasms/*diagnosis/pathology/radiography ; Male ; Middle Aged ; Tomography, X-Ray Computed

OBJECTIVE: To assess the value of applying MultiVane to liver T2-weighted imaging (T2WI) compared with conventional T2WIs with emphasis on detection of focal liver lesions. MATERIALS AND METHODS: Seventy-eight patients (43 men and 35 women) with 86 hepatic lesions and 20 pancreatico-biliary diseases underwent MRI including T2WIs acquired using breath-hold (BH), respiratory-triggered (RT), and MultiVane technique at 3T. Two reviewers evaluated each T2WI with respect to artefacts, organ sharpness, and conspicuity of intrahepatic vessels, hilar duct, and main lesion using five-point scales, and made pairwise comparisons between T2WI sequences for these categories. Diagnostic accuracy (Az) and sensitivity for hepatic lesion detection were evaluated using alternative free-response receiver operating characteristic analysis. RESULTS: MultiVane T2WI was significantly better than BH-T2WI or RT-T2WI for organ sharpness and conspicuity of intrahepatic vessels and main lesion in both separate reviews and pairwise comparisons (p < 0.001). With regard to motion artefacts, MultiVane T2WI or BH-T2WI was better than RT-T2WI (p < 0.001). Conspicuity of hilar duct was better with BH-T2WI than with MultiVane T2WI (p = 0.030) or RT-T2WI (p < 0.001). For detection of 86 hepatic lesions, sensitivity (mean, 97.7%) of MultiVane T2WI was significantly higher than that of BH-T2WI (mean, 89.5%) (p = 0.008) or RT-T2WI (mean, 84.9%) (p = 0.001). CONCLUSION: Applying the MultiVane technique to T2WI of the liver is a promising approach to improving image quality that results in increased detection of focal liver lesions compared with conventional T2WI.
Adult ; Aged ; Aged, 80 and over ; Artifacts ; Biliary Tract Diseases/diagnosis/radiography ; Female ; Humans ; Liver Diseases/*diagnosis/radiography ; Liver Neoplasms/*diagnosis/pathology/radiography ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Pancreatic Diseases/diagnosis/radiography ; Retrospective Studies

No abstract available.
Adenoma, Bile Duct/pathology/*radiography ; Adult ; Aged ; Angiomyolipoma/pathology/*radiography ; Bile Duct Neoplasms/pathology/*radiography ; Bile Ducts, Intrahepatic ; Carcinoma, Hepatocellular/radiography ; Diagnosis, Differential ; Female ; Gadolinium DTPA/*chemistry ; Humans ; Liver Diseases/pathology/*radiography ; Liver Neoplasms/pathology/*radiography ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Pseudolymphoma/pathology/*radiography ; Tomography, X-Ray Computed