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Rare hepatic malignant tumors: dynamic CT, MRI, and clinicopathologic features: with analysis of 54 cases and review of the literature

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Abstract

Aim

To evaluate the dynamic CT, MRI, and clinicopathologic characteristics of rare hepatic malignant tumors (HRMTs), improving the understanding and diagnosis of the tumors.

Methods

A retrospective analysis of 54 cases of HRMTs diagnosed by pathology in our hospital during January 1, 2005 to September 1, 2011.

Results

The types of tumors included hepatic sarcoma (n = 8), malignant lymphoma (n = 4), malignant fibrous histiocytoma (MFH, n = 7), malignant melanoma (MM, n = 4), squamous cell carcinoma (SCC, n = 5), primary clear cell carcinoma of the liver (PCCCL, n = 7), stromal tumors (ST n = 4), hepatoblastoma (HB, n = 8), carcinoid (n = 6), primary primitive neuroectodermal tumor (pPNET, n = 1). Age of the patients ranged from 1 to 79 years (mean = 46.7 years). There were more men in this group (34/54). Symptoms of HRMTs show no specificity. Except PCCCL and HB, the serum AFP of most HRMTs was negative. 43 patients had a single hepatic mass, and 11 patients had multiple hepatic masses. Diameters ranged from 2 to 15 cm (mean = 7.7 cm). Precontrast CT revealed that most masses had uneven density (n = 46) and ill-demarcated margin (n = 37). Enhanced CT showed most lesions unevenly enhanced (n = 49), of which PCCCL had a prompt enhancement in the arterial phase and rapid wash-out on the portal venous phase and delayed phase; malignant lymphoma and ST had slight enhancement, MFH and undifferentiated embryonal sarcoma had gradual delayed enhancement. Most masses had low-signal on T1WI and high-signal on T2WI, while MM had high-signal on T1WI and low-signal on T2WI.

Conclusions

Although there is frequent overlap in the CT, MRI, and clinicopathologic appearances between the rare malignant tumors, some HRMTs have characteristic imaging features that can suggest a specific diagnosis.

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Acknowledgments

This work was supported by The National Natural Science Foundation of China, Nos 30070235, 30470508, and 30870695; The Natural Science Foundation of Hunan Province, Nos 06JJ2008 and 07JJ6040.

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  1. Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China

    Yan Tan & En-hua Xiao

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  1. Yan Tan
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Correspondence to En-hua Xiao.

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Tan, Y., Xiao, Eh. Rare hepatic malignant tumors: dynamic CT, MRI, and clinicopathologic features: with analysis of 54 cases and review of the literature. Abdom Imaging 38, 511–526 (2013). https://doi.org/10.1007/s00261-012-9918-y

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