Extrahepatic Metastases of Hepatocellular Carcinoma1
Sanjeev Katyal, MD,
James H. Oliver, III, MD,
Mark S. Peterson, MD,
James V. Ferris, MD,
Brian S. Carr, MD and
Richard L. Baron, MD
1 From the Departments of Radiology (S.K., J.H.O., M.S.P., J.V.F., R.L.B.) and Transplantation Medicine (B.S.C.), University of Pittsburgh Medical Center, 200 Lothrop St, Pittsburgh, PA 15213. Received November 11, 1999; revision requested December 15; revision received January 7, 2000; accepted January 12. Address correspondence to S.K. (e-mail: katyal@pitt.edu)
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Figure 1a. Transverse contrast-enhanced CT scans in a 53-year-old man with HCC metastases to the lungs. (a) HCC lung metastases (arrows) are nonspecific in appearance (soft-tissue attenuation, without calcification), and patients can undergo biopsy to confirm the diagnosis or can be followed up to document (b) the progression of disease, shown here, in the same patient, who underwent imaging 6 months after a was obtained.
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Figure 1b. Transverse contrast-enhanced CT scans in a 53-year-old man with HCC metastases to the lungs. (a) HCC lung metastases (arrows) are nonspecific in appearance (soft-tissue attenuation, without calcification), and patients can undergo biopsy to confirm the diagnosis or can be followed up to document (b) the progression of disease, shown here, in the same patient, who underwent imaging 6 months after a was obtained.
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Figure 2a. Transverse CT scans in a 26-year-old woman with biopsy-proved metastatic HCC to the lymph nodes. (a) Metastatic lymph node enlargement (arrowheads) may enhance during the hepatic arterial phase; this allows a confident diagnosis of metastatic HCC. (b) In this case, the enhancement of the lymphadenopathy (arrowheads) continues into the portal venous phase.
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Figure 2b. Transverse CT scans in a 26-year-old woman with biopsy-proved metastatic HCC to the lymph nodes. (a) Metastatic lymph node enlargement (arrowheads) may enhance during the hepatic arterial phase; this allows a confident diagnosis of metastatic HCC. (b) In this case, the enhancement of the lymphadenopathy (arrowheads) continues into the portal venous phase.
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Figure 3. Transverse CT scan in a patient with osseous HCC metastases. HCC metastases to the bone always were lytic, as in this 49-year-old woman with a lytic lesion (arrow) that involves the right sacrum.
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Figure 4. Transverse CT scan in a 58-year-old man with biopsy-proved bilateral adrenal HCC metastases. Many of the adrenal metastases (arrows) demonstrated enhancement during the hepatic arterial phase, as in this case, which allowed differentiation from the more common adrenal adenoma.
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Figure 5a. Transverse CT scans show peritoneal and/or omental HCC metastases. Peritoneal and/or omental HCC metastases were identified in 11% of patients with metastatic HCC. The appearance of these metastatic foci can be variable. In our study population, (a) solid soft-tissue omental nodules (arrows), (b) infiltrative and nodular thickening (arrows), or (c) subtle increased peritoneal enhancement (arrows) was seen.
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Figure 5b. Transverse CT scans show peritoneal and/or omental HCC metastases. Peritoneal and/or omental HCC metastases were identified in 11% of patients with metastatic HCC. The appearance of these metastatic foci can be variable. In our study population, (a) solid soft-tissue omental nodules (arrows), (b) infiltrative and nodular thickening (arrows), or (c) subtle increased peritoneal enhancement (arrows) was seen.
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Figure 5c. Transverse CT scans show peritoneal and/or omental HCC metastases. Peritoneal and/or omental HCC metastases were identified in 11% of patients with metastatic HCC. The appearance of these metastatic foci can be variable. In our study population, (a) solid soft-tissue omental nodules (arrows), (b) infiltrative and nodular thickening (arrows), or (c) subtle increased peritoneal enhancement (arrows) was seen.
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Copyright © 2000 by the Radiological Society of North America.
