Contrast-enhanced ultrasonography for the diagnosis of spontaneous necrosis of hepatocellular carcinoma: A report of 2 cases

Yu Ota, MD, PhD; Kazunobu Aso, MD; Shin Otake, MD; Mitsuyoshi Okada, MD; Kounosuke Shukuda, MD; Koji Sawada, MD, PhD; Hideki Yokoo, MD, PhD; Mishie Tanino, MD, PhD; Mikihiro Fujiya, MD, PhD; Toshikatsu Okumura, MD, PhD

Radiology Case Reports (Jan 2023)

Contrast-enhanced ultrasonography for the diagnosis of spontaneous necrosis of hepatocellular carcinoma: A report of 2 cases

Yu Ota, MD, PhD,
Kazunobu Aso, MD,
Shin Otake, MD,
Mitsuyoshi Okada, MD,
Kounosuke Shukuda, MD,
Koji Sawada, MD, PhD,
Hideki Yokoo, MD, PhD,
Mishie Tanino, MD, PhD,
Mikihiro Fujiya, MD, PhD,
Toshikatsu Okumura, MD, PhD

Affiliations

Yu Ota, MD, PhD: Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan; Corresponding author.
Kazunobu Aso, MD: Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan
Shin Otake, MD: Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan
Mitsuyoshi Okada, MD: Gastroenterology and Endoscopy, Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan
Kounosuke Shukuda, MD: Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan
Koji Sawada, MD, PhD: Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan
Hideki Yokoo, MD, PhD: Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan
Mishie Tanino, MD, PhD: Department of Diagnostic Pathology, Asahikawa Medical University Hospital, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan
Mikihiro Fujiya, MD, PhD: Gastroenterology and Endoscopy, Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan
Toshikatsu Okumura, MD, PhD: Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1-1-1, Midorigaoka Higashi, Asahikawa, Hokkaido 078-8510, Japan

Journal volume & issue: Vol. 18, no. 1
pp. 173 – 181

Abstract

Read online

Spontaneous necrosis of hepatocellular carcinoma (HCC) is rare and difficult to diagnose preoperatively if it occurs before the definitive diagnosis of HCC; this is because spontaneous necrosis of HCC exhibits various patterns in imaging studies. We compared imaging and pathological findings, and examined the possibility of diagnosing spontaneous necrosis of HCC using contrast-enhanced ultrasonography (CEUS). We experienced 2 cases of spontaneous necrosis of HCC. In case 1, spontaneous necrosis occurred after HCC diagnosis, while in case 2 it occurred before the first admission. The tumor in case 2 contained internal nodules and outer fibrous tissue. CEUS revealed a vascular spot in the hypovascular area during the vascular phase and a complete defect during the Kupffer phase. These findings accorded with the pathological findings and may be important for diagnosing spontaneous necrosis of HCC.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

About the journal

Abstract

Keywords