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Hepatic Tumors (hepatic + tumor)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

Transplantation	20%
Oncology & Radiotherapy	13%

Selected Abstracts

Multiple hepatic nodules: Rare manifestation of clonorchiasis

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 9 2006
Wei-Chih Liao
Abstract A 38-year-old man was admitted due to intermittent right upper quadrant pain for 1 month. Leukocytosis with marked eosionphilia and elevated serum alkaline phosphatase were noted. Stool examinations revealed no parasites or ova. Ultrasonography and computed tomography disclosed multiple hepatic tumors. Biopsy of the hepatic tumor was performed due to non-conclusive imaging studies and revealed eosinophil infiltration in portal areas only. Endoscopic retrograde cholangiography showed mild dilatation with irregularity of bilateral intrahepatic ducts, compatible with chronic cholangitis. Bile was aspirated and biliary lavage with normal saline was performed during endoscopy-guided biliary cannulation. Microscopic examination of the aspirate showed the characteristic ova of Clonorchis sinensis. The patient received Praziquantel therapy for 1 day. Abdominal pain reduced in intensity gradually. Eosinophilia and multiple hepatic lesions resolved after adequate treatment of Clonorchis sinensis. The rare manifestation of multiple hepatic tumors in Clonorchis sinensis should be differentiated from other primary or metastatic neoplasms, while biliary lavage for parasite ova is a valuable diagnostic tool when stool examination is negative. [source]

Combined hepatocellular carcinoma and cholangiocarcinoma with components of mucinous carcinoma arising in a cirrhotic liver

PATHOLOGY INTERNATIONAL, Issue 4 2006
Daisaku Morita
A rare autopsy case of combined hepatocellular and cholangiocarcinoma, occurring in a 54-year-old man with liver cirrhosis, is presented. Initial laboratory data included CEA 52.1 ng/mL, DUPAN-2 1600 U/mL, AFP 2 ng/mL, and negativity for hepatitis B surface antigen, hepatitis B early antigen and hepatitis B core antibody. Ultrasonography and CT scan showed a large tumor node in the liver with ringed enhancement, swelling of several para-aortic lymph nodes, and ascites. Clinically, it was not possible to determine whether the hepatic tumor was an intrahepatic cholangiocarcinoma or a metastatic carcinoma. Histologically, the primary lesion was composed solely of hepatocellular carcinoma (HCC) with a trabecular pattern, and the intrahepatic metastases consisted of a variable admixture of HCC and cholangiocarcinoma (CC) with excessive mucin production. Interestingly, the tumor cell cluster showing a trabecular growth pattern produced mucin and had immunohistochemical expression of hepatocyte, cytokeratins 7 and 8. It is concluded that these hepatic tumor cells had both HCC and CC characters. [source]

Adrenal rest tumor of the liver: A case report with immunohistochemical investigation of steroidogenesis

PATHOLOGY INTERNATIONAL, Issue 3 2000
Kazumori Arai
Abstract A case of adrenal rest tumor arising in the liver of a 62-year-old male with chronic hepatitis type C is reported. The tumor was clinically non-functioning and required distinction from hepatocellular carcinoma. The yellowish,brown tumor measured 25 × 18 × 15 mm and was located in the subcapsular portion of the right hepatic lobe. Histologically, the tumor presented features similar to those of the adrenal cortex and was predominantly composed of pale cells. Electron micrograph revealed lipid droplets and mitochondria with tubulo,vesicular cristae, consistent with the characteristics of steroid-producing cells. Immunohistochemically, the tumor expressed the adrenal 4 binding protein and a number of enzymes involved in the synthesis of adrenocortical steroids. At surgery, the right adrenal gland was present independently from the liver. This hepatic tumor was considered to be an adrenal rest tumor with steroidogenic capability. [source]

Neonates with severe infantile hepatic hemangioendothelioma: Limitations of liver transplantation

PEDIATRIC TRANSPLANTATION, Issue 5 2009
Enke Grabhorn
Abstract:, IHHE as the most common vascular tumor of the liver in infancy can present with acute postnatal liver and congestive heart failure. LTx may be a lifesaving option, but can be complicated by extrahepatic involvement and bleeding complications, especially in neonates. Here we discuss the benefit of LTx in cases of acute postnatal deterioration and massive extent of the hepatic tumor. Three infants with IHHE were transplanted at our institution between 2005 and 2007. Two were neonates with acute postnatal decompensation and progressive liver and heart failure within days. Treatment with steroids and chemotherapy was ineffective; resection surgery and interventional treatment were not considered appropriate. LTx was performed at the age of 7 and 24 days, respectively. An additional infant with a bilobar tumor that evolved more slowly was transplanted on day-of-life 56. Patients 1 and 2 had to be resuscitated during the LTx procedure because of massive bleeding and both died during the procedure. Patient 3 had a complicated post-operative course but is doing well one-yr post-LTx. Neonates with extended hepatic and extrahepatic involvement of IHHE should be evaluated carefully prior to LTx. Whenever possible, alternative interventional treatment options should be considered. [source]

Unusual evolution of an Epstein,Barr virus-associated leiomyosarcoma occurring after liver transplantation

PEDIATRIC TRANSPLANTATION, Issue 5 2001
Bénédicte Brichard
Abstract: We report the case of a child who developed, 2 yr after orthotopic liver transplantation (OLTx) for biliary atresia, a multi-focal hepatic tumor with lymphonodular metastases, identified as an Epstein,Barr virus (EBV)-associated leiomyosarcoma. Chemotherapy was given without tumor response. Subsequently, slow growth of the tumor was observed. Immunosuppression was tapered and stopped 9 yr after transplantation. At the present time, 12 yr after the discovery of the first hepatic lesions, the patient is alive and completely symptom-free, the abdominal masses are stable, and liver function tests are completely normal. Smooth muscle tumors are increasingly recognized in children with various immunodeficiencies occurring after organ transplantation. This unusual evolution of a clinically aggressive tumor into a stable disease after restoration of immunity confirms that the immune status of the patient is a crucial factor. [source]

Superparamagnetic iron oxide,enhanced magnetic resonance images of hepatocellular carcinoma: Correlation with histological grading

HEPATOLOGY, Issue 2 2000
Ph.D., Yasuharu Imai M.D.
Superparamagnetic iron oxide (SPIO),enhanced magnetic resonance (MR) imaging has been used for the detection of hepatic tumors. However, little is known about this technique in relation to hepatocellular carcinoma (HCC). The aim of this study was to investigate whether SPIO,enhanced MR imaging can be useful in assessing histological grades of HCC. The authors studied histologically proven tumors including 31 HCCs and 6 dysplastic nodules. The ratio of the Kupffer-cell count in the tumorous tissue relative to that in the nontumorous tissue (Kupffer-cell,count ratio) decreased as HCCs became less well differentiated. The ratio of the intensity of the tumorous lesion to that of the nontumorous area on SPIO,enhanced MR images (SPIO intensity ratio) correlated inversely with Kupffer-cell,count ratio in HCCs and dysplastic nodules (r = ,.826, P< .001) and increased as the degree of differentiation of HCCs decreased, indicating that the uptake of SPIO in HCCs decreased as the degree of differentiation of HCCs declined. All of the dysplastic nodules and some well-differentiated HCCs showed hypointense or isointense enhancement, relative to the surrounding liver parenchyma, indicating greater or similar uptake of SPIO in the tumor when compared with nontumorous areas. These results suggest that SPIO,enhanced MR imaging reflects Kupffer-cell numbers in HCCs and dysplastic nodules, and is useful for estimation of histological grading in HCCs, although uncertainties persist in differentiating dysplastic nodules from well-differentiated HCCs. [source]

Anatomic segmental resection compared to major hepatectomy in the treatment of liver neoplasms

HPB, Issue 3 2005
THOMAS S HELLING MD
Abstract Background. Familiarity with liver anatomy and refinements in operative technique have led to interest in liver conservation when dealing with hepatic tumors. There is thought to be less morbidity, less blood loss (EBL), a shorter hospital stay (LOS), and no penalty for long-term survival with segmental hepatectomy. Methods. One hundred ninety-six patients who underwent segmental (SEG group) (N=70) or major (MAJOR group) (N=126) hepatectomy for liver neoplasms were retrospectively reviewed. Clinical parameters of mortality, morbidity, EBL, LOS, and actuarial survival in patients with colorectal metastases were examined. Results. There were no differences in age or gender between the SEG and MAJOR groups. There were no deaths among 64 non-cirrhotic patients in the SEG group and 4 deaths (3.2%) among 124 non-cirrhotic patients in the MAJOR group (p=0.19). There were 4 postoperative complications in the SEG group (5.6%) and 22 in the MAJOR group (17.3%) (p<0.05). The EBL for the SEG group was 912±842 ml compared to 3675±3110 ml in the MAJOR group (p<0.001). The hospital LOS for the SEG group was 9.4±6.4 days and for the MAJOR group 10.2±5.9 days (p=0.32). Life table analysis of survival for resection of colorectal metastases showed two-year patient survival of 40% in the SEG group (N=17) and 45% for the MAJOR group (N=46). Conclusion. Segmental resections were associated with less EBL and fewer postoperative complications. There was a trend towards fewer deaths in non-cirrhotic patients, and no apparent penalty for a smaller hepatic resection in long-term survival. While sometimes technically more challenging, segmental resections are preferable when feasible and should be utilized in efforts to conserve liver parenchyma. [source]

Radiofrequency ablation of hepatic tumors: Lessons learned from 3000 procedures

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 10 2008
Hyunchul Rhim
Abstract Radiofrequency ablation has been accepted as the most popular local ablative therapy for unresectable malignant hepatic tumors. For 9 years from April 1999, we performed 3000 radiofrequency ablation procedures for hepatic tumors in our institution. Our results on the safety (mortality, 0.15%/patient) and therapeutic efficacy (5-year survival rate, 58%) are similar to those of previous studies reported, supporting the growing evidence of a clear survival benefit, excellent results for local tumor control and improved quality of life. The most important lesson learned from our 3000 procedures is that the best planning, safe ablation and complete ablation are key factors for patient outcome. Furthermore, multimodality treatment is the best strategy for recurrent hepatocellular carcinoma encountered after any kind of first-line treatment. [source]

Multiple hepatic nodules: Rare manifestation of clonorchiasis

Modified radiofrequency-assisted liver resection: A new device

JOURNAL OF SURGICAL ONCOLOGY, Issue 3 2007
Dimitris Zacharoulis MD
Abstract Background Radiofrequency ablation (RF) is emerging as new therapeutic method for the management of hepatic tumors. So far the RF-assisted hepatectomy has been described using an electrode initially designed for ablation of unresectable tumors. Herein, we describe a new technique for liver resection using a bipolar radiofrequency device. Method Ten patients undergo liver resection using a bipolar radiofrequency device. A minimal zone of desiccation around the tumor is created between pairs of opposing electrodes as a result of a minimum amount of energy released. This coagulated plane can be divided with a scalpel. Results The liver parenchyma was divided with minimal blood loss. No intensive care unit admission was needed. There was no postoperative biliary leak or any other septic complication. Conclusion The technique is safe and feasible, simplifies liver resection and appears to be associated with minimal morbidity and maximum liver parenchyma preservation. J. Surg. Oncol. 2007;96: 254,257. © 2007 Wiley-Liss, Inc. [source]

Liver transplantation in association with hepatocellular carcinoma: An update of the international tumor registry

LIVER TRANSPLANTATION, Issue 9 2002
Ernesto P. Molmenti
Hepatocellular carcinoma is an epithelial tumor derived from hepatocytes that accounts for more than 80% of all primary hepatic tumors. The severity of the underlying disease is almost always the key factor in deciding whether to consider liver resection or transplantation as its treatment. Data in our registry corresponding to almost 800 patients from transplant centers throughout the world showed that patient survival after liver transplantation was significantly affected by histologic grade, tumor size >5 cm, and the presence of positive nodes. Recurrence-free survival showed a correlation with tumor size >5 cm, positive nodes, bilobar spread, and vascular invasion. At the present time, 59% of patients in our registry are alive, 84% of whom are free of tumor. Of those who died, half did so without evidence of tumor. [source]

Real-time MR temperature mapping of rabbit liver in vivo during thermal ablation

MAGNETIC RESONANCE IN MEDICINE, Issue 2 2003
Claudia Weidensteiner
Abstract It has been shown that quantitative MRI thermometry using the proton resonance frequency (PRF) method can be used to noninvasively monitor the evolution of tissue temperature, and to guide minimally-invasive tumor ablation based on local hyperthermia. Although hepatic tumors are among the main targets for thermal ablation, PRF-based temperature MRI of the liver is difficult to perform because of motion artifacts, fat content, and low T. In this study the stability of real-time thermometry was tested on a clinical 1.5 T scanner for rabbit liver in vivo. The fast segmented EPI principle was used together with respiratory gating to limit respiratory motion artifacts. Lipid signal suppression was achieved with a binomial excitation pulse. Saturation slabs were applied to suppress artifacts due to flowing blood. The respiratory-gated MR thermometry in the rabbit liver in vivo showed a standard deviation (SD) of 1,3°C with a temporal resolution of 3 s per slice and 1.4 mm × 1.9 mm spatial resolution in plane (slice thickness = 5 mm). The method was used to guide thermal ablation experiments with a clinical infrared laser. The estimated size of the necrotic area, based on the thermal dose calculated from MR temperature maps, corresponded well with the actual lesion size determined by histology and conventional MR images obtained 5 days posttreatment. These results show that quantitative MR temperature mapping can be obtained in the liver in vivo, and can be used for real-time control of thermal ablation and for lesion size prediction. Magn Reson Med 50:322,330, 2003. © 2003 Wiley-Liss, Inc. [source]

Hepatic intraductal oncocytic papillary carcinoma

CANCER, Issue 10 2002
Robert C. G. Martin M.D.
Abstract BACKGROUND There has been an increasing incidence and mortality from peripheral cholangiocarcinoma (PC) in the United States over the past 24 years. PC has been classified into two principal types, a mass-forming type and a periductal-infiltrating type, with a significant difference in the clinical behavior between the two. A third type, demonstrating a noninvasive intraductal growth of PC, was described as papillary PC. Rarely, papillary hepatic tumors composed of oncocytic cells have been described. Intraductal oncocytic papillary carcinomas (IOPCs) of the liver present as large, mucin-filled, cystic lesions lined by noninvasive or focally microinvasive oncocytic tumors. METHODS From June 1999 to August 2001, three patients with hepatic IOPCs were identified in the files of the Hepatobiliary Service, Department of Surgery, and the Department of Pathology at Memorial Sloan-Kettering Cancer Center. They form the basis of this study. We report the clinicopathologic presentation, as well as the outcome, with a review of the literature. RESULTS All three cases presented with well defined intrahepatic cystic masses ranging in size from 7.2 to 21.1 cm. The most prominent cells of the lining epithelium were columnar with oncocytic features showing abundant eosinophilic granular cytoplasm and centrally located nucleoli. All three patients underwent resection with one demonstrating local bile duct recurrence that was managed with stenting. Review of the literature has identified 39 patients with papillary PC and 2 patients with IOPC. The biology of these reported cases has been variable with overall survival better than that of nonpapillary PC patients, with recurrence in 15% of the reported cases. CONCLUSION Papillary PC is a rare type of cholangiocarcinoma that includes an interesting variant: IOPC. These tumors are predominantly found in men, who present with large (> 5 cm) mucinous cystic lesions of the bile duct. A noninvasive histology is seen, and long-term survival may be achieved with complete resection. Invasive variants of IOPC have been reported in the literature and have a worse overall prognosis. Cancer 2002;95:2180,7. © 2002 American Cancer Society. DOI 10.1002/cncr.10934 [source]