title: Liver metastasis from hepatoid adenocarcinoma of the stomach mimicking hepatocellular carcinoma: Dynamic computed tomography findings.
abstract: OBJECTIVE
  To evaluate the dynamic computed tomography (CT) findings of liver metastasis from hepatoid adenocarcinoma of the stomach (HAS) and compared them with hepatocellular carcinoma (HCC).
  
  
  METHODS
  Between January 2000 and January 2015, 8 patients with pathologically proven HAS and liver metastases were enrolled. Basic tumor status was evaluated for the primary tumor location and metastatic sites. The CT findings of the liver metastases were analyzed for tumor number and size, presence of tumor necrosis, hemorrhage, venous tumor thrombosis, and dynamic enhancing pattern.
  
  
  RESULTS
  The body and antrum were the most common site for primary HAS (n = 7), and observed metastatic sites included the liver (n = 8), lymph nodes (n = 7), peritoneum (n = 4), and lung (n = 2). Most of the liver metastases exhibited tumor necrosis regardless of tumor size. By contrast, tumor hemorrhage was observed only in liver lesions larger than 5 cm (n = 4). Three patterns of venous tumor thrombosis were identified: direct venous invasion by the primary HAS (n = 1), direct venous invasion by the liver metastases (n = 7), and isolated portal vein tumor thrombosis (n = 2). Dynamic CT revealed arterial hyperattenuation and late phase washout in all the liver metastases.
  
  
  CONCLUSIONS
  On dynamic CT, liver metastasis from HAS shared many imaging similarities with HCC. For liver nodules, the presence of isolated portal vein tumor thrombosis and a tendency for tumor necrosis are imaging clues that suggest the diagnosis of HAS.
authors.affiliation: Yang-Yu Lin, Chien-Ming Chen, Sung-Yu Chu, Ming-Yi Hsu, Kuang-Tse Pan, Jeng-Hwei Tseng, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Yang-Yu
authors.initials: YY
authors.lastname: Lin
authors.affiliation: Yang-Yu Lin, Chien-Ming Chen, Sung-Yu Chu, Ming-Yi Hsu, Kuang-Tse Pan, Jeng-Hwei Tseng, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Chen
authors.affiliation: Yang-Yu Lin, Chien-Ming Chen, Sung-Yu Chu, Ming-Yi Hsu, Kuang-Tse Pan, Jeng-Hwei Tseng, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Yu-Hsiu
authors.initials: YH
authors.lastname: Huang
authors.affiliation: Yang-Yu Lin, Chien-Ming Chen, Sung-Yu Chu, Ming-Yi Hsu, Kuang-Tse Pan, Jeng-Hwei Tseng, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Cheng-Yu
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Yang-Yu Lin, Chien-Ming Chen, Sung-Yu Chu, Ming-Yi Hsu, Kuang-Tse Pan, Jeng-Hwei Tseng, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Sung-Yu
authors.initials: SY
authors.lastname: Chu
authors.affiliation: Yang-Yu Lin, Chien-Ming Chen, Sung-Yu Chu, Ming-Yi Hsu, Kuang-Tse Pan, Jeng-Hwei Tseng, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Ming-Yi
authors.initials: MY
authors.lastname: Hsu
authors.affiliation: Yang-Yu Lin, Chien-Ming Chen, Sung-Yu Chu, Ming-Yi Hsu, Kuang-Tse Pan, Jeng-Hwei Tseng, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Kuang-Tse
authors.initials: KT
authors.lastname: Pan
authors.affiliation: Yang-Yu Lin, Chien-Ming Chen, Sung-Yu Chu, Ming-Yi Hsu, Kuang-Tse Pan, Jeng-Hwei Tseng, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou and Chang Gung University, Taoyuan 333, Taiwan.
authors.forename: Jeng-Hwei
authors.initials: JH
authors.lastname: Tseng
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000556:secondary*; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Hepatocellular carcinoma; Hepatoid adenocarcinoma; Liver; Stomach