Clinicopathologic features of hepatic neoplasms in explanted livers: a single institution experience.
BACKGROUND
Hepatic neoplasms can be the primary indication for hepatic transplantation. The tumors can also be incidentally identified in explanted livers. We explored the clinicopathologic features of hepatic neoplasms identified in explanted livers.


METHODS
All explanted livers resected between 2001 and 2006 were evaluated for the presence of neoplasms and their clinicopathologic features were examined.


RESULTS
In 98 liver transplants, 15 neoplasms (15.3%) were identified. Patient ages ranged from 5 to 63 years (median, 56 years). The primary etiology of hepatic disease was hepatitis C virus in 12 cases, hepatitis B virus in 1 case, cryptigenic cirrhosis in 1 case and congenital hepatic fibrosis in 1 case. Serum alpha-fetoprotein was significantly elevated (>400 U/L) in only 2 cases. CA19-9 was not elevated in any of the cases. The tumors included hepatocellular carcinoma (HCC) in 13 cases, 1 case of choloangiocarcinoma and 1 case of combined HCC and hepatoblastoma. The tumors in size from 0.5 to 5 cm (median 1.4 cm) and were multifocal in 5 of the cases (33%). Tissue alpha-fetoprotein expression was only seen in the cases associated with elevated serum levels.


CONCLUSIONS
In our institution hepatic neoplasms are seen in more than 15% explanted livers. They can be incidentally indentified, are frequently not associated with elevated serum levels of alpha-fetoprotein and CA19-9, are commonly multifocal but small, and are associated with good prgonosis. Elevated serum alpha-fetoprotein, albeit specific, is not a very sensitive marker in the detection of hepatic neoplasms.
Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. wmourad@hotmail.com
Walid
W
Mourad
Hatem
H
Khalaf
Asma
A
Tulbah
Mohammed
M
Al Omari
Hadeel
H
Al Mana
Mohamed
M
Neimatallah
D000293:Adolescent; D000328:Adult; D018395:CA-19-9 Antigen / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D018281:Cholangiocarcinoma / Q000209:etiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D015870:Gene Expression; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D018197:Hepatoblastoma / Q000209:etiology / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000209:etiology* / Q000473:pathology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D000509:alpha-Fetoproteins / Q000032:analysis
D018395:CA-19-9 Antigen; D000509:alpha-Fetoproteins