Min-Yung Chang1,2,3, Hye Jin Kim1,2,4, Seung Hyun Park1,2, Hyunki Kim5, Dong Kyu Choi6, Joon Seok Lim1,2, Mi-Suk Park1,2, Myeong-Jin Kim1,2, Honsoul Kim7,8. 1. Department of Radiology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. 2. Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea. 4. Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea. 5. Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea. 6. New Drug Development Center, Daegu-Gyeongbuk, Medical Innovation Foundation (DGMIF), Daegu, Republic of Korea. 7. Department of Radiology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. pine0205@yuhs.ac. 8. Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea. pine0205@yuhs.ac.
Abstract
PURPOSE: The purpose of this study was to report the imaging presentation of hepatic metastases from hepatoid adenocarcinoma (HAC). METHODS: We retrospectively identified 11 patients (10 men and 1 woman; median age 66) with HAC liver metastasis who underwent contrast-enhanced computed tomography (CT) which included arterial phase and portal venous phase. Two radiologists analyzed the imaging parameters, which included the enhancement pattern on arterial and portal phase images, necrosis, venous thrombi, and overall imaging diagnosis, and arrived at a consensus. RESULTS: On arterial phase, the liver lesions had global hyper-enhancement (n = 0), heterogeneous hyper-enhancement (63.6%; n = 7/11), peripheral hyper-enhancement (n = 0), iso-enhancement (n = 0/11), or hypo-enhancement (36.4%; n = 4/11). On portal venous phase, homogenous hypo-enhancement (18.2%; n = 2/11) and heterogenous hypo-enhancement (81.8%; n = 9/11) were observed. Venous thromboses occurred in four patients (36.4%; n = 4/11). The overall imaging diagnoses were "HCC-like" in seven patients (63.6%; n = 7/11), "indeterminable" in 1 patient (9.1%; n = 1/11), and "HCC-unlike" in three patients (27.3%; n = 3/11). CONCLUSIONS: The imaging features of HAC liver metastasis were varied. Arterial phase enhancement coupled with venous phase washout (resembling HCC imaging features) was a major finding, but arterial phase hypo-enhancement (distinct from HCC imaging features) was also frequently encountered.
PURPOSE: The purpose of this study was to report the imaging presentation of hepatic metastases from hepatoid adenocarcinoma (HAC). METHODS: We retrospectively identified 11 patients (10 men and 1 woman; median age 66) with HAC liver metastasis who underwent contrast-enhanced computed tomography (CT) which included arterial phase and portal venous phase. Two radiologists analyzed the imaging parameters, which included the enhancement pattern on arterial and portal phase images, necrosis, venous thrombi, and overall imaging diagnosis, and arrived at a consensus. RESULTS: On arterial phase, the liver lesions had global hyper-enhancement (n = 0), heterogeneous hyper-enhancement (63.6%; n = 7/11), peripheral hyper-enhancement (n = 0), iso-enhancement (n = 0/11), or hypo-enhancement (36.4%; n = 4/11). On portal venous phase, homogenous hypo-enhancement (18.2%; n = 2/11) and heterogenous hypo-enhancement (81.8%; n = 9/11) were observed. Venous thromboses occurred in four patients (36.4%; n = 4/11). The overall imaging diagnoses were "HCC-like" in seven patients (63.6%; n = 7/11), "indeterminable" in 1 patient (9.1%; n = 1/11), and "HCC-unlike" in three patients (27.3%; n = 3/11). CONCLUSIONS: The imaging features of HAC liver metastasis were varied. Arterial phase enhancement coupled with venous phase washout (resembling HCC imaging features) was a major finding, but arterial phase hypo-enhancement (distinct from HCC imaging features) was also frequently encountered.
Authors: Alexander N Levy; Rachel Ackerman; Osman Yilmaz; Caroline Jouhourian; Manish Tandon; Michael W Winter Journal: ACG Case Rep J Date: 2019-05-17