Ripresa di malattia extraepatica e seconde neoplasie in pazienti trattati per carcinoma epatocellulare: Quadri diagnostici

Translated title of the contribution: Extrahepatic recurrence and second malignancies after treatment of hepatocellular carcinoma: Spectrum of imaging findings

Massimo Tonolini, Luigi Solbiati, Tiziana Ierace, Valentina Kirn, Fausto Croce

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose. To describe diagnostic imaging features (with a focus on CT findings) of extrahepatic relapses of treated hepatocellular carcinoma and to propose a post-treatment follow-up protocol. Material and methods. During a six-year span, 226 patients (aged 32-88 years) with chronic hepatitis/cirrhosis were diagnosed as having hepatocellular carcinoma confined to the liver and treated percutaneously with radiofrequency (RF) ablation. A total of 313 treatment sessions were performed. Post-therapeutic follow-up is based upon clinical evaluation, laboratory and imaging (with CT holding the key role) studies. Results. Mean duration of follow-up was 17 months. After successful treatment, actuarial probability of neoplastic relapse is 30.7% after 1 year and 58.5% after 2 years. Eighty-eight patients had recurrence of hepatocellular carcinoma after a variable time interval (mean 7.3 months). Extrahepatic neoplastic relapse was observed in 14 patients, half of these without active hepatic disease. Distribution of extrahepatic sites of recurrence was as follows: abdominal lymph nodes (6 cases), bone (3), peritoneum (2), adrenal (2), lung (1). Five patients (2.2%) had a second primary neoplasm. Conclusions. Extrahepatic hepatocellular carcinoma is uncommon and occurs in advanced stages, but may represent a pattern of post-treatment relapse. The distinctive hypervascularity of this tumour histology may be observed in adenopathies and adrenal metastases. Second primary neoplasms should be considered in the differential diagnosis of lesions observed during follow-up.

Original languageItalian
Pages (from-to)196-205
Number of pages10
JournalRadiologia Medica
Volume103
Issue number3
Publication statusPublished - Mar 2002

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Second Primary Neoplasms
Hepatocellular Carcinoma
Recurrence
Therapeutics
Liver
Peritoneum
Diagnostic Imaging
Chronic Hepatitis
Histology
Differential Diagnosis
Fibrosis
Lymph Nodes
Neoplasm Metastasis
Bone and Bones
Lung
Neoplasms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Ripresa di malattia extraepatica e seconde neoplasie in pazienti trattati per carcinoma epatocellulare : Quadri diagnostici. / Tonolini, Massimo; Solbiati, Luigi; Ierace, Tiziana; Kirn, Valentina; Croce, Fausto.

In: Radiologia Medica, Vol. 103, No. 3, 03.2002, p. 196-205.

Research output: Contribution to journalArticle

Tonolini, Massimo ; Solbiati, Luigi ; Ierace, Tiziana ; Kirn, Valentina ; Croce, Fausto. / Ripresa di malattia extraepatica e seconde neoplasie in pazienti trattati per carcinoma epatocellulare : Quadri diagnostici. In: Radiologia Medica. 2002 ; Vol. 103, No. 3. pp. 196-205.
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abstract = "Purpose. To describe diagnostic imaging features (with a focus on CT findings) of extrahepatic relapses of treated hepatocellular carcinoma and to propose a post-treatment follow-up protocol. Material and methods. During a six-year span, 226 patients (aged 32-88 years) with chronic hepatitis/cirrhosis were diagnosed as having hepatocellular carcinoma confined to the liver and treated percutaneously with radiofrequency (RF) ablation. A total of 313 treatment sessions were performed. Post-therapeutic follow-up is based upon clinical evaluation, laboratory and imaging (with CT holding the key role) studies. Results. Mean duration of follow-up was 17 months. After successful treatment, actuarial probability of neoplastic relapse is 30.7{\%} after 1 year and 58.5{\%} after 2 years. Eighty-eight patients had recurrence of hepatocellular carcinoma after a variable time interval (mean 7.3 months). Extrahepatic neoplastic relapse was observed in 14 patients, half of these without active hepatic disease. Distribution of extrahepatic sites of recurrence was as follows: abdominal lymph nodes (6 cases), bone (3), peritoneum (2), adrenal (2), lung (1). Five patients (2.2{\%}) had a second primary neoplasm. Conclusions. Extrahepatic hepatocellular carcinoma is uncommon and occurs in advanced stages, but may represent a pattern of post-treatment relapse. The distinctive hypervascularity of this tumour histology may be observed in adenopathies and adrenal metastases. Second primary neoplasms should be considered in the differential diagnosis of lesions observed during follow-up.",
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