[Hepatocellular carcinoma (HCC) observed in Abidjan: aspects and role of ultrasonography].

In this retrospective study, we define the localization and ultrasound appearances of hepatocellular carcinomas observed in Abidjan. The study included 31 inpatients (23 males and 8 females), aged from 24 to 76 years (mean, 47.4). All patients had serum alphafetoprotein dosage and 21 patients had cytologic examination. Diagnosis was based on a high level of serum alpha-fetoprotein (> 500 ng/ml), with or without cytological proof. Tumor characteristics (size, number, echogenicity, nodular or diffuse form) and associated extratumoral signs were noted. Ultrasound identified 19 cases of small tumors (size < 5 cm), and 12 large tumors (size > or = 5 cm). The tumor forms were mostly nodular and multiple (24 cases), solitary nodule (3 cases), diffuse or infiltrative (4 cases). The liver was heterogeneous with hyperechoic tumoral nodules (16 cases), hypoechoic tumoral nodules (5 cases), hyperechoic and diffuse form (4 cases), and 2 cases of mixed form. We have noted a particular form in 4 cases represented by a heterogeneous liquid-like mass simulating tropical abscesses. Ascites (12 patient) was the most common extratumoral sign. Portal vein invasion or thrombus was rare (3 patients). Of the 31 patients, ultrasound was abnormal in all cases, alpha-fetoprotein test was positive in 12 cases (57.14%) and negative in 9 cases (42.8%). Cytological test was positive in 17 cases (80.95%), and negative in 4 cases (19.04%). Alphafetoprotein and cytologic tests were both positive in 8 cases and, nonconcordant in 13 cases; in 4 cases alphafetoprotein was positive while cytological tests were negative and, in 9 cases alphafetoprotein was negative while cytological tests were positive. Two negative tests were never observed. In Abidjan, hepatocellular carcinomas are commonly small or large, multinodular and hyperechoic tumors contrasting with the small nodular and hypoechoic tumors usually reported in western series. Ultrasound associated with cytologic examination, appears to us to be more usefulness than alphafetoprotein dosage in the diagnosis of hepatocellular carcinoma.