Hepatocellular-cholangiocarcinoma: helical computed tomography findings in 30 patients.
OBJECTIVE
To report the helical multiphasic computed tomography (CT) findings in 30 patients with hepatocellular-cholangiocarcinoma.


METHODS
We evaluated age, gender, tumor risk factors, serum tumor markers, symptoms, and tumor morphology and enhancement on helical multiphasic CT in 30 patients.


RESULTS
Twenty-six of 30 patients (86%) were men. Patients had an age range of 27-78 years (mean = 58 years). Abdominal signs or symptoms were present in 21 of 30 patients, and 25 of 30 (83%) had chronic liver disease. Helical CT demonstrated a well-defined tumor in all patients with signs of malignancy such as hepatic hypervascularity (63%), biliary obstruction (17%), satellite lesions (40%), and lymphadenopathy (27%). Portions of the tumor were hyperattenuated on arterial-phase imaging and hypoattenuated on all other phases, whereas other portions showed delayed persistent enhancement, sometimes (27%) with hepatic capsular retraction, findings that have been reported to be characteristic of hepatocellular carcinoma and cholangiocarcinoma, respectively.


CONCLUSIONS
The diagnosis of hepatocellular-cholangiocarcinoma should be considered when a hepatic tumor has CT features of both hepatocellular carcinoma and cholangiocarcinoma. Radiologists should be aware of this tumor type so that the biopsy is performed properly to allow sufficient tissue sampling.
Ebied
Osama
O
Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Federle
Michael P
MP
Blachar
Arye
A
Brancatelli
Giuseppe
G
Grazioli
Luigi
L
Cazals-Hatem
Dominique
D
Dondero
Federica
F
Vilgrain
Valérie
V
D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000097:blood / Q000145:classification / Q000175:diagnosis*; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging; D014408:Biomarkers, Tumor / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000145:classification / Q000175:diagnosis*; D018281:Cholangiocarcinoma / Q000097:blood / Q000145:classification / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000145:classification / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000097:blood / Q000145:classification / Q000175:diagnosis; D010414:Pennsylvania; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed; D000509:alpha-Fetoproteins / Q000378:metabolism
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D000509:alpha-Fetoproteins