Evaluation of hepatocellular carcinoma supplied by the right inferior phrenic artery at initial treatment.
OBJECTIVE
Recurrent hepatocellular carcinoma (HCC) often occurs with extrahepatic supply because of various factors. The right inferior phrenic artery (RIPA) is the most frequent extrahepatic feeding artery, however, it is rarely found that the RIPA supplies the tumor in patients with HCC at initial treatment. The purpose of this study is to evaluate the radiological findings of untreated cases of HCC fed by the RIPA.


METHODS
Medical records, computed tomography scans, and angiograms in 14 patients with HCC fed by the RIPA at initial therapy were reviewed. We evaluated growth pattern, size, location of tumors, and patency of the hepatic artery.


RESULTS
In all cases, tumors showed exophytic growth. Eleven cases (79%) were massive type. Tumor size ranged from 4.5 cm to 16.8 cm (mean, 11.1 cm). In 11 cases (79%), tumors were mainly located in liver segment 7. The patency of the hepatic arteries was intact in all cases.


CONCLUSIONS
Regardless of initial therapy, HCC with exophytic growth pattern, especially located in the hepatic areas directly beneath the diaphragm and of massive type, can be supplied by the RIPA.
Hieda
Masashi
M
Department of Radiology, Division of Medical Intelligence and Informatics, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan. hieda@hiroshima-u.ac.jp
Toyota
Naoyuki
N
Kakizawa
Hideaki
H
Hirai
Nobuhiko
N
Tachikake
Toshihiro
T
Matsuura
Noriaki
N
Ishikawa
Masaki
M
Ito
Katsuhide
K
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging* / Q000628:therapy*; D011379:Prognosis; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome