Hepatocellular carcinoma(HCC)is the most common primary hepatic malignancy,which usually arises in cirrhotic liver.When the typical enhancement pattern,consisting of late arterial hyperenhancement followed by washout,...Hepatocellular carcinoma(HCC)is the most common primary hepatic malignancy,which usually arises in cirrhotic liver.When the typical enhancement pattern,consisting of late arterial hyperenhancement followed by washout,is present in nodules larger than 1 cm,HCC can be confidently diagnosed without the need for tissue biopsy.Nevertheless,HCC can display an atypical enhancement pattern,either as iso or hypovascular lesion,or hypervascular lesion without washout.Not only the enhancement pattern of HCC could be atypical,but also a variety of histological types of HCC,such as steatotic,scirrhous,fibrolamellar,or combined hepatocellular-cholangiocellular carcinoma could raise diagnostic dilemmas.In addition,distinct morphological types of HCC or different growth pattern can occur.Awareness of these atypical and rare HCC presentations on magnetic resonance imaging is important for accurate differentiation from other focal liver lesions and timely diagnosis,which allows optimal treatment of patients.展开更多
BACKGROUND Low grade fibromyxoid sarcoma(LGFMS)is a rare and benign mesenchymal tumor with indolent course,most commonly found in young or middle-aged men.The majority of the LGFMSs are located in the trunk and deep s...BACKGROUND Low grade fibromyxoid sarcoma(LGFMS)is a rare and benign mesenchymal tumor with indolent course,most commonly found in young or middle-aged men.The majority of the LGFMSs are located in the trunk and deep soft tissue of the lower extremities.They appear as well circumscribed,although not encapsulated,which often leads to incomplete surgical resection.Despite their seemingly benign appearance,these tumors have aggressive behavior with high metastatic and recurrence rates.Accurate histopathologic examination of the specimen and its immunohistochemical analysis are mandatory for a precise diagnosis.CASE SUMMARY We report a case of a 38 year-old-man who presented with jaundice and upper abdominal discomfort.Multi-detector computed tomography and magnetic resonance imaging showed a large left liver tumor mass,extending to the hepatoduodenal ligament.Left hepatectomy was performed with resection and reconstruction of hepatic artery and preservation of middle hepatic vein.Histopathologic examination confirmed the tumor being a low-grade fibromyxoid sarcoma.Three and a half years after surgery,the patient died after being diagnosed with spine metastasis.CONCLUSION Due to poor response to all modalities of adjuvant treatment,we consider that the focus of treatment should be on surgery as the only option for curing the disease.展开更多
文摘Hepatocellular carcinoma(HCC)is the most common primary hepatic malignancy,which usually arises in cirrhotic liver.When the typical enhancement pattern,consisting of late arterial hyperenhancement followed by washout,is present in nodules larger than 1 cm,HCC can be confidently diagnosed without the need for tissue biopsy.Nevertheless,HCC can display an atypical enhancement pattern,either as iso or hypovascular lesion,or hypervascular lesion without washout.Not only the enhancement pattern of HCC could be atypical,but also a variety of histological types of HCC,such as steatotic,scirrhous,fibrolamellar,or combined hepatocellular-cholangiocellular carcinoma could raise diagnostic dilemmas.In addition,distinct morphological types of HCC or different growth pattern can occur.Awareness of these atypical and rare HCC presentations on magnetic resonance imaging is important for accurate differentiation from other focal liver lesions and timely diagnosis,which allows optimal treatment of patients.
文摘BACKGROUND Low grade fibromyxoid sarcoma(LGFMS)is a rare and benign mesenchymal tumor with indolent course,most commonly found in young or middle-aged men.The majority of the LGFMSs are located in the trunk and deep soft tissue of the lower extremities.They appear as well circumscribed,although not encapsulated,which often leads to incomplete surgical resection.Despite their seemingly benign appearance,these tumors have aggressive behavior with high metastatic and recurrence rates.Accurate histopathologic examination of the specimen and its immunohistochemical analysis are mandatory for a precise diagnosis.CASE SUMMARY We report a case of a 38 year-old-man who presented with jaundice and upper abdominal discomfort.Multi-detector computed tomography and magnetic resonance imaging showed a large left liver tumor mass,extending to the hepatoduodenal ligament.Left hepatectomy was performed with resection and reconstruction of hepatic artery and preservation of middle hepatic vein.Histopathologic examination confirmed the tumor being a low-grade fibromyxoid sarcoma.Three and a half years after surgery,the patient died after being diagnosed with spine metastasis.CONCLUSION Due to poor response to all modalities of adjuvant treatment,we consider that the focus of treatment should be on surgery as the only option for curing the disease.
