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Nam Young Jo 1 Article
Hypovascular Hepatocellular Carcinoma Supposed to Originate from Dysplastic Nodule
Nam Young Jo, Soon Ho Um, Kum Won Kim, Yun Hwan Kim, Nam Hee Won
Journal of the Korean Liver Cancer Study Group. 2003;3(1):87-91.   Published online July 31, 2003
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Hepatocellular carcinoma (HCC) typically shows hepatic arterial phase contrast-enhancement and wash out pattern at portal phase. Hepatic dysplastic nodules show diverse imaging characteristics but commonly show hypoattenuation pattern at CT-imaging. We report an 3 cm sized atypical hypovascular HCC which was thought to orginate from dysplastic nodule. Fifty senven year old female who had suffered from chronic hepatitis B had three separate hepatic nodules initially. One in seg 7 diagnosed as well-differentiated HCC, another in seg 5 as dysplastic nodule by US guided needle biopsy. Remaining 1.5 cm sized nodule in seg 4 which showed isoattenuation at arterial phase and hypoattenuation at portal phase. We avoid invasive treatment to seg 4 nodule due to vicinity of great vessel. We performed transarterial chemoembolization (TACE) and percutaneous ethanol injection to the seg 7 & seg 5 lesions and followed up with TACE. At 2 years later the nodule in seg 4 grew up to 3 cm sized mass with showed persistency no arterial phase enhancement and partially hypoattenuating-isoattenuating pattern at portal phase. The mass diagnosed as clear cell type HCC (Edmoson grade Ⅱ) by US guided biopsy.
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JLC : Journal of Liver Cancer