Rare hepatic malignant tumors: dynamic CT, MRI, and clinicopathologic features: with analysis of 54 cases and review of the literature.
OBJECTIVE
To evaluate the dynamic CT, MRI, and clinicopathologic characteristics of rare hepatic malignant tumors (HRMTs), improving the understanding and diagnosis of the tumors.


METHODS
A retrospective analysis of 54 cases of HRMTs diagnosed by pathology in our hospital during January 1, 2005 to September 1, 2011.


RESULTS
The types of tumors included hepatic sarcoma (n = 8), malignant lymphoma (n = 4), malignant fibrous histiocytoma (MFH, n = 7), malignant melanoma (MM, n = 4), squamous cell carcinoma (SCC, n = 5), primary clear cell carcinoma of the liver (PCCCL, n = 7), stromal tumors (ST n = 4), hepatoblastoma (HB, n = 8), carcinoid (n = 6), primary primitive neuroectodermal tumor (pPNET, n = 1). Age of the patients ranged from 1 to 79 years (mean = 46.7 years). There were more men in this group (34/54). Symptoms of HRMTs show no specificity. Except PCCCL and HB, the serum AFP of most HRMTs was negative. 43 patients had a single hepatic mass, and 11 patients had multiple hepatic masses. Diameters ranged from 2 to 15 cm (mean = 7.7 cm). Precontrast CT revealed that most masses had uneven density (n = 46) and ill-demarcated margin (n = 37). Enhanced CT showed most lesions unevenly enhanced (n = 49), of which PCCCL had a prompt enhancement in the arterial phase and rapid wash-out on the portal venous phase and delayed phase; malignant lymphoma and ST had slight enhancement, MFH and undifferentiated embryonal sarcoma had gradual delayed enhancement. Most masses had low-signal on T1WI and high-signal on T2WI, while MM had high-signal on T1WI and low-signal on T2WI.


CONCLUSIONS
Although there is frequent overlap in the CT, MRI, and clinicopathologic appearances between the rare malignant tumors, some HRMTs have characteristic imaging features that can suggest a specific diagnosis.
Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Yan
Y
Tan
En-hua
EH
Xiao
D000293:Adolescent; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D051677:Histiocytoma, Malignant Fibrous / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008223:Lymphoma / Q000175:diagnosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018242:Neuroectodermal Tumors, Primitive / Q000175:diagnosis / Q000473:pathology; D012189:Retrospective Studies; D012509:Sarcoma / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D055815:Young Adult