A case of poorly differentiated hepatocellular carcinoma with intriguing ultrasonography findings

Wakui,Noritaka; Takayama,Ryuji; Matsukiyo,Yasushi; Mukouzu,Takanori; Kanayama,Masahiro; Takahashi,Masayoshi; Nagai,Hidenari; Watanabe,Manabu; Maruyama,Kenichi; Kaneko,Masahiro; Shibuya,Kazutoshi; Sumino,Yasukiyo

doi:10.3892/ol.2012.764

September 2012 Volume 4 Issue 3

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

September 2012 Volume 4 Issue 3

Full Size Image

Article

A case of poorly differentiated hepatocellular carcinoma with intriguing ultrasonography findings

Authors:
- Noritaka Wakui
- Ryuji Takayama
- Yasushi Matsukiyo
- Takanori Mukouzu
- Masahiro Kanayama
- Masayoshi Takahashi
- Hidenari Nagai
- Manabu Watanabe
- Kenichi Maruyama
- Masahiro Kaneko
- Kazutoshi Shibuya
- Yasukiyo Sumino
View Affiliations / Copyright

Affiliations: Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Ota-ku, Tokyo 143-8541, Japan, Division of Clinical Functional Physiology, Toho University Omori Medical Center, Ota-ku, Tokyo 143-8541, Japan, Division of Hepato-Biliary-Pancreatic Surgery, Toho University Omori Medical Center, Ota-ku, Tokyo 143-8541, Japan, Division of Surgical Pathology, Toho University Omori Medical Center, Ota-ku, Tokyo 143-8541, Japan
Pages: 393-397
|
Published online on: June 19, 2012

https://doi.org/10.3892/ol.2012.764
Expand metrics +

Abstract

A 60‑year‑old female was referred to the Toho University Omori Medical Center due to ultrasonography findings revealing a notable hepatic mass. The 44x32 mm isoechoic mass had a high‑echo band along the margin in the liver. Contrast‑enhanced ultrasonography (CEUS) with Sonazoid detected an enhancement pattern extending from the outer periphery to the inside of the mass in the vascular phase and a pattern similar to that of surrounding hepatic tissue in the post‑vascular phase. High‑flow hepatic hemangioma was suspected due to the hyperechoic rim‑like high-echo band, the oval shape and the CEUS findings. However, computed tomography revealed a hypervascular hepatocellular carcinoma (HCC) pattern and the patient underwent surgery. Histopathological findings revealed poorly differentiated HCC. As poorly and moderately differentiated HCC types are conventionally classified as ‘hypervascular HCC’, few detailed ultrasonography (US) studies of poorly differentiated HCC are available. US characteristics of hypervascular HCC include the presence of a halo (hypoechoic band) around the lesion and reduced signal intensity in the post‑vascular phase of CEUS. US in the patient revealed a mass with a hyperechoic band and a signal intensity in the post‑vascular phase of CEUS that was almost identical to that of the surrounding liver parenchyma. These findings suggest poorly differentiated HCC and indicate that further research on hypervascular HCC is required.

View Figures

View References

1	Nakajima Y, Shimamura T, Kamiyama T, Kimura J, Sato N, Matsushita M, Une Y and Uchino J: Evaluation of surgical resection for small hepatocellular carcinomas. Am J Surg. 171:360–363. 1996. View Article : Google Scholar : PubMed/NCBI
2	Jonas S, Bechstein WO, Steinmüller T, Herrmann M, Radke C, Berg T, Settmacher U and Neuhaus P: Vascular invasion and histopathologic grading determine outcome after liver transplantation for hepatocellular carcinoma in cirrhosis. Hepatology. 33:1080–1086. 2001. View Article : Google Scholar
3	Ohkuma K: Ultrasound diagnosis. Jpn J Cancer Clin. 47:987–994. 2001.(In Japanese).
4	Shunichi S, Hiroko I, Fuminori M and Waki H: Definition of contrast enhancement phases of the liver using a perfluoro-based microbubble agent, perflubutane microbubbles. Ultrasound Med Biol. 35:1819–1827. 2009. View Article : Google Scholar
5	Tobe K, Tsuchiya T and Fujiwara R: Kupffer cells in well-differentiated tissue of hepatocellular carcinoma. Acta Hepatol Jpn. 26:630–637. 1985.(In Japanese with English abstract).
6	Sugihara S, Nakashima O and Kiyomatsu K: Pathomorphologic study on macrophages in hepatocellular carcinoma. Acta Hepatol Jpn. 31:12–18. 1999.(In Japanese with English abstract).
7	Tanaka M, Nakashima O, Wada Y, Kage M and Kojiro M: Pathomorphological study of Kupffer cells in hepatocellular carcinoma and hyperplastic nodular lesions in the liver. Hepatology. 24:807–812. 1996. View Article : Google Scholar : PubMed/NCBI
8	Yabuuchi I, Matuda Y and Ifuji T: Classification of contrast enhanced US images of small hepatocellular carcinoma using Levovist. Kan Tan Sui. 47:175–182. 2003.(In Japanese with English abstract).
9	Ikai I, Arii S, Okazaki M, Okita K, Omata M, Kojiro M, Takayasu K, Nakanuma Y, Makuuchi M, Matsuyama Y, Monden M and Kudo M: Report of the 17th Nationwide Follow-up Survey of Primary Liver Cancer in Japan. Hepatol Res. 37:676–691. 2007. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

A case of poorly differentiated hepatocellular carcinoma with intriguing ultrasonography findings

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Figure 8

Related Articles