Skip to main content

Advertisement

SpringerLink
Log in

Myxoid hepatocellular neoplasms: imaging appearance of a unique mucinous tumor variant

  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To describe the imaging appearance of myxoid hepatocellular neoplasms (MHNs), including adenomas and carcinomas, a recently described pathologically unique tumor variant.

Materials and Methods

Single-institution review of pathologically proven MHNs revealed 4 patients with imaging prior to resection. All available cross-sectional imaging was then retrospectively reviewed in consensus using specified descriptive characteristics previously published for hepatocellular adenoma subtypes. Imaging characteristics on magnetic resonance imaging (MRI), ultrasound (US), and computed tomography (CT) were reviewed.

Results

MHNs were predominantly markedly T2 hyperintense with thin internal septations, circumscribed with lobulated margins, and demonstrated heterogeneous enhancement on arterial phase that became more homogenous on delayed phases. The lesions were hypodense on CT with similar enhancement characteristics as on MRI. On US, they were mildly hyperechoic and heterogeneous with posterior acoustic enhancement.

Conclusion

MHNs show distinct imaging features that may allow accurate noninvasive diagnosis and differentiation from other hepatic lesions, including cavernous hemangioma, focal nodular hyperplasia, and other variants of hepatocellular adenoma or carcinoma. Differentiation between benign and malignant MHN may not be possible by imaging, possibly necessitating earlier definitive therapy or surgical management

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Galassi A, Pasquinelle G, Guerini A, Martinelli G, Venza E (1995) Benign myxoid hepatocellular tumor: a variant of liver cell adenoma. Liver 15(5):233–235

    Article  CAS  PubMed  Google Scholar 

  2. Salaria SN, Graham RP, Aishima S, et al. (2015) Primary hepatic tumors with myxoid change: morphologically unique hepatic adenomas and hepatocellular carcinomas. Am J Surg Pathol 39(3):318–324

    Article  PubMed  Google Scholar 

  3. Lee CU, Glockner JF Mayo Clinic body MRI case review. Mayo Clinic scientific press, Florence

  4. van Aalten SM, Thomeer MG, Terkivatan T, et al. (2011) Hepatocellular adenomas: correlation of MR imaging findings with pathologic subtype classification. Radiology 261(1):172–181

    Article  PubMed  Google Scholar 

  5. Dhingra S, Fiel MI (2014) Update on the new classification of hepatic adenomas: clinical, molecular, and pathologic characteristics. Arch Pathol Lab Med 138(8):1090–1097. doi:10.5858/arpa.2013-0183-RA

    Article  PubMed  Google Scholar 

  6. Blanc JF, Frulio N, Chiche L, et al. (2015) Hepatocellular adenoma management: call for shared guidelines and multidisciplinary approach. Clin Res Hepatol Gastroenterol 39(2):180–187

    Article  PubMed  Google Scholar 

  7. Baheti AD, Tirumani SH, Rosenthal MH, et al. (2015) Myxoid soft-tissue neoplasms: comprehensive update of the taxonomy and MRI features. Am J Roentgenol 204(2):374–385. doi:10.2214/ajr.14.12888

    Article  Google Scholar 

  8. Murphey MD, McRae GA, Fanburg-Smith JC, et al. (2002) Imaging of soft-tissue myxoma with emphasis on CT and MR and comparison of radiologic and pathologic findings. Radiology 225(1):215–224

    Article  PubMed  Google Scholar 

  9. Semelka RC, Brown ED, Ascher SM, et al. (1994) Hepatic hemangiomas: a multi-institutional study of appearance on T2-weighted and serial gadolinium-enhanced gradient-echo MR images. Radiology 192(2):401–406. doi:10.1148/radiology.192.2.8029404

    Article  CAS  PubMed  Google Scholar 

  10. Hussain SM, Terkivatan T, Zondervan PE, et al. (2004) Focal nodular hyperplasia: findings at state-of-the-art MR imaging, US, CT, and pathologic analysis. Radiographics 24(1):3–17

    Article  PubMed  Google Scholar 

  11. Chung YE, Kim M-J, Park YN, et al. (2009) Varying appearances of cholangiocarcinoma: radiologic-pathologic correlation. Radiographics 29(3):683–700. doi:10.1148/rg.293085729

    Article  PubMed  Google Scholar 

  12. McEvoy SH, McCarthy CJ, Lavelle LP, et al. (2013) Hepatocellular carcinoma: illustrated guide to systematic radiologic diagnosis and staging according to guidelines of the American Association for the Study of Liver Diseases. Radiographics 33(6):1653–1668. doi:10.1148/rg.336125104

    Article  PubMed  Google Scholar 

  13. Wells ML, Venkatesh SK, Chandan VS, et al. (2015) Biphenotypic hepatic tumors: imaging findings and review of literature. Abdom Imaging. 40(7):2293–2305. doi:10.1007/s00261-015-0433-9

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Abdominal Imaging, Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Jesse T. Young, Anil N. Kurup & Sudhakar K. Venkatesh

  2. Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA

    Rondell P. Graham & Michael S. Torbenson

Authors
  1. Jesse T. Young
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anil N. Kurup
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rondell P. Graham
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael S. Torbenson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sudhakar K. Venkatesh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sudhakar K. Venkatesh.

Ethics declarations

Funding

No funding was received for this study.

Conflicts of Interest

None of the authors have any conflicts of interest to disclose.

Ethical approval

Institutional review board approval was obtained with waiver of consent for retrospective review of image and clinical data.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Young, J.T., Kurup, A.N., Graham, R.P. et al. Myxoid hepatocellular neoplasms: imaging appearance of a unique mucinous tumor variant. Abdom Radiol 41, 2115–2122 (2016). https://doi.org/10.1007/s00261-016-0812-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-016-0812-x

Keywords

Search

Navigation