title: Small hepatocellular carcinoma presenting with massive metastasis in the peritoneum, mimicking sarcomatous tumor.
abstract: The case of a 51-year-old man with hepatitis C virus (HCV)-related hepatocellular carcinoma metastasizing to the peritoneal cavity and mimicking a sarcomatous tumor is presented. A 12 x 12 cm mass, disclosed by computed tomography (CT), in the peritoneal cavity was predominantly isodense to muscle but had hypodense areas that suggested necrosis. T1-weighted magnetic resonance imaging (MRI) showed a large mass, slightly hyperintense to muscle, with local hyperintense areas of suspected hemorrhagic necrosis.T2-weighted MRI of the same region revealed a markedly non-homogeneous and hyperintense mass with inner high signals and peripheral brush-like linear striations. From such imaging studies, sarcomatous tumors, such as fibrosarcoma, leiomyosarcoma, and gastrointestinal stromal tumors, can be distinguished. Pathological findings at autopsy revealed necrotic tissue with a small portion of moderately differentiated HCC. Further studies may provide insights into the metastatic modes of HCC.
authors.affiliation: Department of Gastroenterology, Kobe Asahi Hospital, Kobe, Japan.
authors.forename: Soo Ryang
authors.initials: SR
authors.lastname: Kim
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ikawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Ando
authors.forename: Keiji
authors.initials: K
authors.lastname: Mita
authors.forename: Shuichi
authors.initials: S
authors.lastname: Fuki
authors.forename: Susumu
authors.initials: S
authors.lastname: Imoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Shimizu
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kanbara
authors.forename: Koji
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Fujii
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Matsuoka
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hayashi