Seeding from hepatocellular carcinoma after percutaneous ablation: color Doppler ultrasound findings

Abstract

Clinical and imaging findings of seeding from HCC should be recognized by physicians who perform follow-up ultrasound examinations of patients who are treated with PAT. Early diagnosis of seeding can be reliably made by scanning the abdominal wall with small probes in the area where the previous PAT has been performed. Hypoechoic hypervascular pattern of the seeding nodule allows definitive diagnosis.

Intrahepatic dissemination of hepatocellular carcinoma after local ablation therapy

“…They concluded that only previous tumor biopsy was associated with extrahepatic tumor seeding. Tarantino et al 22 reported that extrahepatic seeding after PEIT for HCC occurred at a frequency of 0.2% to 1.4%. In the present study, needle biopsies prior to LAT were performed in only two patients (25%).…”

Needle Tract Implantation after Percutaneous Interventional Procedures in Hepatocellular Carcinomas: Lessons Learned from a 10-year Experience

“…Percutaneous ethanol injection therapy is a low risk, well-established treatment for small HCCs, but can lead to needle tract implantation (11, 12, 17). Although alcohol was thought to sterilize the needle tract and prevent implantation after PEIT (12), the frequency of needle tract implantation is between 0.2%-1.4% (11, 17).…”

“…Although alcohol was thought to sterilize the needle tract and prevent implantation after PEIT (12), the frequency of needle tract implantation is between 0.2%-1.4% (11, 17). PEIT may increase the risk of needle tract implantation compared with biopsy alone because PEIT requires multiple needle punctures over an extended period, despite the advantage of a smaller caliber needle (21-22 gauge) (11).…”

“…Although needle tract implantation does not usually affect patient survival (7, 9, 11-14, 17), it may change a potentially curable HCC into an untreatable situation via tumor dissemination to other organs or the peritoneum (22). Therefore, minimizing needle tract implantation is important, as is detection early during tumor growth, which can then be treated successfully by surgical excision (7, 9).…”

“…Implanted tumors were not treated in the remaining three patients because of recurrent HCCs in the liver and/or a poor medical condition. Needle tract implantation can alo be managed by ablation, embolization, or radiation therapy (10-12, 14, 17). …”