Clinical and imaging characteristics of primary hepatic sarcomatoid carcinoma and sarcoma: a comparative study

Abstract

Background Primary hepatic sarcomatous carcinoma (PHSC) and primary hepatic sarcoma (PHS) are rare malignancies with frequent overlap in both the clinic and radiology. No comparative study of these tumors for the restricted cases has previously been undertaken. The purpose of our study was to analyze the clinical and imaging features of PHSCs and PHSs, with an emphasis on particularities and similarities through a comparison of the two tumors. Methods We retrospectively analyzed the clinical and imaging features of 39 patients with pathologically proven PHSCs (n = 23) and PHSs (n = 16) from four university centers over a 9-year period from 2010 to 2019. Univariate analyses were performed to determine the consistent and distinctive features. Results The background of chronic hepatitis or cirrhosis was observed with a high frequency in both of PHSCs (73.7%) and PHSs (62.5%). Tumors with a diameter greater than 10 cm were significantly more common in PHSs than PHSCs (p = 0.043) and cystic masses were more detected in PHSs (P = 0.041). Both PHSCs and PHSs mainly presented hypovascularity (78.3% vs 81.3%). The ring hyper enhancement on the arterial phase (AP) and wash out were more frequently seen in PHSCs and the iso-hypo enhancement on the AP followed persistent or progressive enhancement was more commonly detected in PHSs (all, p < 0.05). Conclusion PHSC and PHS generally present as mass lesions with hypovascularity. The ring hyper enhancement on the AP and wash out favor the diagnosis of PHSC. The large size greater than 10 cm, cystic lesion, iso-hypo persistent or progressive enhancement pattern might suggest the possibility of PHSs.

A retrospective study on the clinical and pathological features of hepatic sarcomatoid carcinoma: Fourteen cases of a rare tumor

“…This was not significantly different from the mean overall survival (4 months) of patients treated with symptomatic and supportive care. Studies have reported that HSCs are hypovascular tumors, [29] and TACE is a risk factor associated with poor prognosis. [30] For patients with unresectable intrahepatic recurrence, TACE can help prolong the survival of patients, [31] which may be due to the rich blood supply of new tumors and the strong dependence of tumors on blood vessels.…”

Surgery after combination therapy with a tyrosine kinase inhibitor and anti-PD-1 antibody in sarcomatoid hepatocellular carcinoma: case report and literature review

“…Upper abdominal pain appeared gradually with enlargement of the tumor; the patient also demonstrated typical clinical manifestations. As there are no specific tumor markers for SHC, imaging is the mainstay for detection of the lesions ( 18 ).…”

Dynamic contrast-enhanced CT and clinical features of sarcomatoid hepatocellular carcinoma

“…In addition, among the four lesions with hepatic surface retraction, three tumors lacked capsules and one had partial capsule, indicating that most of them were prone to invade peripheral regions owing to the lack of limitation of complete capsule. Furthermore, it should be noted that the differential diagnosis should also include liver metastases, liver abscess, scirrhous subtype of HCC and primary hepatic sarcoma, which all could present as “slow-in and and slow-out” enhancement pattern, with larger size, lobulated or wavy contours and infiltrative morphology in some cases [ 12 , 26 , 27 ].…”