Hepatocellular carcinoma with sarcomatous change: characteristic findings of two-phased incremental CT.
BACKGROUND
Because of its poor prognosis, the diagnosis of hepatocellular carcinoma with sarcomatous change (HCCSC) is clinically important. The purpose of this study is to elucidate the characteristic CT findings of HCCSC.


METHODS
Two-phased dynamic incremental CT images of six histologically proven HCCSC were retrospectively reviewed.


RESULTS
All tumors (100%) exhibited peripheral enhancement on delayed CT images. Lymphadenopathy was observed in 100% (six of six patients); intrahepatic metastases, in 83% (five of six). Both metastatic lesions showed findings similar to those of the primary hepatic tumors, such as peripheral enhancement. Histopathological delayed and/or prolonged peripherally enhanced areas consisted of viable cancer cells with sarcomatous changes.


CONCLUSIONS
The appearance of HCCSC on CT is that of an irregularly demarcated intrahepatic mass with delayed or prolonged peripheral enhancement, frequently with intrahepatic metastases and lymphadenopathy.
Honda
H
H
Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Hayashi
T
T
Yoshida
K
K
Takenaka
K
K
Kaneko
K
K
Fukuya
T
T
Tateshi
Y
Y
Ro
T
T
Maeda
T
T
Masuda
K
K
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D007479:Iopamidol; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007479:Iopamidol