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Malignant Liver Tumors (malignant + liver_tumor)
Selected AbstractsLiving-Donor Liver Transplantation for HepatoblastomaAMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2005Mureo Kasahara Hepatoblastoma is the most common malignant liver tumor in children. Recently, liver transplantation has been indicated for unresectable hepatoblastoma. We retrospectively reviewed 14 children with a diagnosis of hepatoblastoma who had undergone living-donor liver transplantation (LDLT) at Kyoto University Hospital. During the period from June 1990 to December 2004, 607 children underwent LDLT. Of these interventions, 2.3% were performed for hepatoblastoma. Based on radiological findings, the pre-treatment extent of disease (PRETEXT) grouping was used for pre-treatment staging of the tumor. There were grade III in seven patients and grade IV in seven patients. Thirteen patients received chemotherapy, and seven underwent hepatectomy 11 times. Immunosuppressive treatment consisted of tacrolimus monotherapy in 11 patients. Actuarial 1- and 5-year graft and patient survival rates were 78.6% and 65.5%. The poor prognostic factors were macroscopic venous invasion and extrahepatic involvement with 1-year and 5-year survival rates of 33.0% and 0%. Pediatric patients without these factors showed an acceptable 5-year survival rate of 90.9%. LDLT provides a valuable alternative with excellent results in children with hepatoblastoma because it allows optimal timing of the liver transplantation, given the absence of delay between the completion of chemotherapy and planned liver transplantation. [source] Contrast media-enhanced power Doppler sonography for evaluation of hemangiomas and malignant tumors in the liverJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 1 2003AYDIN KARABACAKOGLU Abstract Aim: To evaluate the characterization of liver hemangiomas and malignant tumors using power Doppler sonography before and after intravenous injection of a sonocontrast agent. Methods: Forty-five patients with 57 liver tumors (22 hemangiomas, 24 metastases, 10 hepatocellular carcinomas (HCC) and one cholangiocellular carcinoma) were examined prospectively. The distribution (peripheral, central, mosaic) and extent (none, minimal, moderate and strong) of intratumoral flow pattern in each sonographic examination was subjectively classified. Results: The administration of the sonocontrast agent by bolus injection caused enhancement to gradually increase up to 2 min and lasted for 4,5 min. After injection of contrast agent, flow signals appeared or increased in 34 tumors. No signal enhancement was observed in 18 hemangiomas, four metastases and one HCC. The sensitivity and specificity of intratumoral vascularity for the detection of malignant liver tumors was 37.1 and 90.9% for unenhanced power Doppler sonography, and 85.7 and 81.8% for contrast-enhanced power Doppler sonography, respectively. Conclusion: Contrast-enhanced power Doppler sonography is superior to unenhanced power Doppler sonography in the demonstration of malignant tumor vascularity, and is helpful in differentiating between hemangiomas and malignant liver tumors. A specific flow pattern within the tumor is not established in primary and metastatic malignant tumors with contrast-enhanced power Doppler sonography. © 2003 Blackwell Publishing Asia Pty Ltd [source] Comparison of ferucarbotran-enhanced fluid-attenuated inversion-recovery echo-planar, T2-weighted turbo spin-echo, T2*-weighted gradient-echo, and diffusion-weighted echo-planar imaging for detection of malignant liver lesionsJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 3 2010Yoshihiko Fukukura MD Abstract Purpose: To compare the diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced fluid-attenuated inversion-recovery echo-planar imaging (FLAIR EPI) for malignant liver tumors with that of T2-weighted turbo spin-echo (TSE), T2*-weighted gradient-echo (GRE), and diffusion-weighted echo-planar imaging (DW EPI). Materials and Methods: SPIO-enhanced magnetic resonance imaging (MRI) that included FLAIR EPI, T2-weighted TSE, T2*-weighted GRE, and DW EPI sequences was performed using a 3 T system in 54 consecutive patients who underwent surgical exploration with intraoperative ultrasonography. A total of 88 malignant liver tumors were evaluated. Images were reviewed independently by two blinded observers who used a 5-point confidence scale to identify lesions. Results were correlated with results of histopathologic findings and surgical exploration with intraoperative ultrasonography. The accuracy of each MRI sequence was measured with jackknife alternative free-response receiver operating characteristic analysis. The sensitivity of each observer with each MRI sequence was compared with McNemar's test. Results: Accuracy values were significantly higher with FLAIR EPI sequence (0.93) than with T2*-weighted GRE (0.80) or DW EPI sequences (0.80) (P < 0.05). Sensitivity was significantly higher with the FLAIR EPI sequence than with any of the other sequences. Conclusion: SPIO-enhanced FLAIR EPI sequence was more accurate in the diagnosis of malignant liver tumors than T2*-weighted GRE and DW EPI sequences. SPIO-enhanced FLAIR EPI sequence is helpful for the detection of malignant liver tumors. J. Magn. Reson. Imaging 2010;31:607,616. ©2010 Wiley-Liss, Inc. [source] Preliminary experience with arterial chemoembolization for hepatoblastoma and hepatocellular carcinoma in childrenPEDIATRIC BLOOD & CANCER, Issue 7 2006Piotr Czauderna MD Abstract The objective of this work was to test feasibility and efficacy of hepatic artery chemoembolization (HACE) in unresectable malignant liver tumors. Five patients aged from 1,12 years were treated in the Medical University of Gdansk from 1999 to 2002. All had locally advanced tumors, which did not respond to systemic chemotherapy: four, hepatoblastoma (HB) and one, hepatocellular carcinoma (HCC). Arteriography was performed and chemoembolization suspension (cisplatin,+,doxorubicin,+,mitomycin mixed with lipiodol) was injected, followed by gelatin foam particles. The procedure was performed one to three times in each patient. In four patients (three, HB, one, fibrolamellar HCC), tumor response was observed, with decrease in the diameter of the mass of 25,33% and fall in the AFP level of 83,99%. One child with HB was non-evaluable due to early death caused by systemic myelotoxicity. Two patients (2 HB) underwent macroscopically complete tumor resection, 1 is alive and well, and 1 died at the end of surgery for an unknown reason (possibly related to cardiotoxicity of earlier systemic chemotherapy). One HB patient was successfully transplanted after two HACE courses. The only HCC patient died because of pulmonary oil embolism immediately after the third HACE course. HACE can lead to tumor regression in most cases and may be considered an alternative for patients with unresectable liver tumors who do not respond to primary systemic chemotherapy and are not candidates for liver transplantation for various reasons. © 2005 Wiley-Liss, Inc. [source] | ||||||||||