title: Radiological and clinical features of sarcomatoid hepatocellular carcinoma in 11 cases.
abstract: OBJECTIVE
  To evaluate the imaging and clinical findings of pathologically proven sarcomatoid hepatocellular carcinoma (HCC) in 11 cases.
  
  
  METHODS
  We retrospectively reviewed the imaging findings and clinical features of 11 patients with pathologically proven sarcomatoid HCC at 2 university-based tertiary institutions from July 1997 to June 2006.
  
  
  RESULTS
  The most common gross morphologies of sarcomatoid HCC were massive expanding pattern (n = 6 [54%]) or multinodular confluent (n = 5 [46%]) with partial encapsulation (n = 9 [82%]). The most common enhancement pattern was peripheral enhancement with central necrosis (n = 8 [72%]) without a dominant dynamic pattern of enhancement. Six (54%) of 11 patients were positive for hepatitis B surface antigen or hepatitis C virus antibody. Only 1 patient (9%) had more than 500 ng/mL of preoperative serum alpha-fetoprotein.
  
  
  CONCLUSIONS
  In a patient with low-level alpha-fetoprotein and no history of viral hepatitis, sarcomatoid HCC usually presents as a large mass with peripheral enhancement, central necrosis, variable enhancement of the solid portion with or without tumor capsule, and intrahepatic metastasis.
authors.affiliation: Department of Diagnostic Radiology, Institute of Gastroenterology, Research Institute of Radiological Science, Severance Hospital, Seoul, South Korea.
authors.forename: Hye Ryoung
authors.initials: HR
authors.lastname: Koo
authors.forename: Mi-Suk
authors.initials: MS
authors.lastname: Park
authors.forename: Myeong-Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Joon Suk
authors.initials: JS
authors.lastname: Lim
authors.forename: Jeong-Sik
authors.initials: JS
authors.lastname: Yu
authors.forename: Hur
authors.initials: H
authors.lastname: Jin
authors.forename: Ki Whang
authors.initials: KW
authors.lastname: Kim
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed