Obstructions of portal veins and tumor numbers are associated with humped hepatocellular carcinoma.
Tumor protrusion in hepatocellular carcinoma (HCC) is one of the risk signs of tumor rupture. Despite curative tumor treatments, HCC recurrences sometimes occur with rapidly growing humped or ruptured HCC in small sized tumors. The aim of this study was to clarify the characteristics of humped HCC clinically and radiologically associated with tumor progression, liver damage, and treatment. The subjects were 179 consecutive HCC patients who underwent angiographic examination. Dynamic studies, using helical computed tomography and magnetic resonance imaging were assessed, and the HCC area were measured. The tumor-node-metastasis (TNM) stage differed significantly between the humped and non-humped HCC groups. Humped HCC was more frequently observed in the right lobe (29.3% of right-lobe HCCs) than in the left (10.1%; p=0.003). Analysis of recurrent HCC revealed that patients with multiple treatments of >4 sessions had more humped HCC (33.8%) than those with 1-3 sessions (16.7%; p=0.042). Multivariate regression analysis revealed that tumor invasion in the portal vein, rather than large tumor size, was significantly associated with tumor protrusion. HCC recurrence with humped HCC occurs often in patients with multiple treatments. Tumor factors of the TNM classification, especially tumor invasion in the portal vein, might be associated with the mechanisms of tumor protrusion.
Department of Radiology, Sumitomo Besshi Hospital, Niihama, Ehime 792-8543, Japan. takayuki_sanomura@ni.sbh.gr.jp
Takayuki
T
Sanomura
Fusao
F
Ikeda
Tsutomu
T
Katoh
Kazue
K
Hosokawa
Seiyuu
S
Suzuki
Yoshihiro
Y
Nishiyama
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000145:classification* / Q000000981:diagnostic imaging / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000145:classification* / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology*; D009367:Neoplasm Staging; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed