A study of minute hepatocellular carcinoma

Abstract

Forty-nine patients with primary carcinoma of the liver were surgically treated at our hospital through 1961. Four cases with minute hepatocellular carcinoma which were subjected to liver resection were investigated.1. Twenty cases of this series underwent liver resection and their resectability was 41.7%. Of these 20 cases, 16 were concomitant with fibrosis or cirrhosis for back ground.Patients with such a cancer show poor prognosis and autopsy were performed on 10 cases.Histological findings showed marked proliferation of connective tissues and invasion of its fiber into the pseudolobules in the residual liver than the resected liver. Of 4 cases with minute hepatocellular carcinoma, 2 were positive serum AFP andHBs-Ag level and 3 were found tumor stain in hepatic arteriogram and low density area in hepatoscintigram.3. On gross specimen with minute cancer, all of them were of the single nodular type with capsule formation which were histologically found invasion of carcinoma. Tumors larger than 3.0cm in size revealed tumor necrosis, tumor thrombus in the portal vein and rupture of the hepatic capusules. Above findings indicated that those cases should be subjected to radical operation such as segmental resection or hepatic lobectomy.

Hepatic resection for hepatocellular carcinoma associated with liver cirrhosis

“…A hepatoma of less than 2 cm in maximum diameter is listed as small liver cancer in an agreement concerning primary liver cancer of Japan in 1983 [8]. But in this study, tumors of less than 5 cm were treated as small tumors, as seen in other reports [3][4][5]. Although our patients with small tumors have been diagnosed for only the past 11 years, we can assume an increase in the number of these patients at all institutions in the future, and this may be considered therapeutically significant.…”

“…In an investigation of The Liver Cancer Study Group of Japan in 1976 [3], these capsules were recognized among 50% of the patients with hepatic resection and 39% of the patients autopsied. Shimoyama et al [4] stated, however, that all of their patients had a capsule. Therefore, the incidence of its existence differs according to each investigator.…”

“…On the contrary, among our patients the nodular type was high at 74%, because half of our patients consisted of those who had small tumors of the nodular type. Patients with small tumors who were studied by Shimoyama et al [4] and Shinagawa and colleagues [9] also exhibited tumors of the nodular type. Although there is concern about the existence of the tumor capsule, 59% of our patients had this capsule.…”

“…Patients with small tumors (small liver cancer) [3][4][5] have been seen in Japan recently, and we are also interested in the therapeutic results of these patients. In this study, patients with both diseases who underwent hepatic resection were divided into large and small tumor groups and evaluated.…”

Hepatocellular carcinoma: Prospective assessments of the T-factor with CT, US, and MR imaging

“…The prognosis of HCCs greater than 2 cm in diameter is poorer than that of those equal to or less than 2 cm in diameter [15]. This is attributed to the fact that HCCs with more than 2 cm in diameter more frequently accompany daughter nodules and invade the portal vein and the capsules of the tumor [15]. Thus, accurate estimates of tumor sizes are important for conjecturing the prognoses of patients after therapy, P-Vp, pathological classification for portal invasion Table 4.…”