No abstract

This retrospective study examined the computed tomography (CT) criteria for judging the effectiveness of transcatheter arterial Lipiodol-chemoembolization (Lp-chemo-TAE) in 35 cases with hepatocellular carcinoma (HCC). Massive necrosis, defined as involving 97% or more of the HCC nodule, was observed in 15 cases after Lp-chemo-TAE, whereas nonmassive necrosis, defined as involving < or = 96% of the HCC nodule, was observed in the remaining 20 cases. In 12 of 15 cases (80%) with massive necrosis, uniform dense retention of Lipiodol (Lp) was observed throughout the HCC nodule on CT images 3-4 weeks after Lp-chemo-TAE as opposed to only one (5%) of 20 cases with nonmassive necrosis (p < 0.01). Eight of nine cases (89%) with massive necrosis had tumor attenuation values of 365 Hounsfield units (HU) or greater on CT images 3-4 weeks after embolization, as opposed to only four (27%) of 15 cases with nonmassive necrosis (p < 0.01). We conclude that the effectiveness of the Lp-chemo-TAE can be judged on CT from the degree and duration of Lp retention in the HCC nodule and the measurement of the attenuation value of the HCC nodule.

We experienced seven cases of hepatocellular carcinoma (HCC) with extrahepatic primary malignant neoplasms (PMNs), which accounted for 7.5% of 93 HCC cases in our department during a 5.5-year investigation period. No common characteristics of the seven patients with extrahepatic PMNs in terms of age, sex, computed tomographic (CT) features of hepatocellular carcinoma, or presence of liver cirrhosis were evident. One of the seven cases had triple PMNs. Extrahepatic PMNs were found in various organs: stomach, colon, kidney, lung, larynx, and esophagus. Attention to extrahepatic organs should be undertaken in the management of HCC. Two patients in hepatic coma died 4 and 6 months after the diagnosis of HCC due to the advanced HCC, and accompanying extrahepatic malignancies were not the primary cause of death.

Tumor thrombus (TT) in the inferior vena cava (IVC) and right atrium (RA) is rarely encountered. We have diagnosed before death and treated a case of hepatocellular carcinoma (HCC) with TT in the IVC and RA, accompanied by a brain metastasis. The image characteristics on computed tomography (CT), magnetic resonance imaging (MRI), and conventional angiography are discussed.

In nearly half of patients, spiral CTA shows various shapes of small nonpathological focal enhancements more frequently in the liver edge.