Long Xingyun, Shen Haiyun, Wu Jie, Liu Han, Huang Danqing, Kong Wentao
Department of Ultrasonography, Nanjing Drum Tower Hospital, Drum Tower Clinical Medical College, Nanjing Medical University, Nanjing, 21009, China.
Department of Ultrasonography, Drum Tower Clinical Medical College, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, 21009, China.
BMC Cancer. 2025 Jan 2;25(1):2. doi: 10.1186/s12885-024-13367-3.
Hepatic sarcomatoid carcinoma (HSC) and hepatic sarcoma (HS) are rare malignancies. Without pathology, the differential diagnosis between these two tumors is difficult due to their frequent overlaps in clinical presentations and imaging features. Currently, there are limited analyses about the ultrasound (US), contrast-enhanced ultrasound (CEUS) and contrast-enhanced computer tomography (CECT) characteristics of HSC and HS. Therefore, the purpose of our study is to evaluate the value of US, CEUS and CECT on the differential diagnosis between HSC and HS.
From 2015 to 2022, a total of 23 patients with HSC (n = 11) and HS (n = 12) are included in this retrospective study. We analyze the clinical, pathological, and imaging data of these patients. Analysis of differences is performed to determine the consistent and distinctive features.
HSCs have a considerably higher prevalence of chronic hepatitis (p = 0.005) and cirrhosis (p = 0.027) than HSs, while metastases are more prevalent in HSs (p = 0.005). The lesion size of HSCs (8.1 ± 2.2 cm) is slightly larger than that of HSs (6.2 ± 3.4 cm). On conventional US, the characteristics of HS and HSC are similar. In CEUS, HSCs consistently showed heterogeneous enhancement patterns, while HSs, particularly hepatic angiosarcoma (HA), demonstrated a higher prevalence of hyperintensity (75%). On CECT, all masses in both groups exhibited low density. A statistically significant difference in margin clarity was observed between HSC and HS (p = 0.015).
HSC and HS generally present as masses with hypo-echoic and hypo-vascularity. HSC usually presents heterogeneous density. The degree of enhancement, the time of wash-out start, and the presence of necrotic areas may contribute to distinguish the different pathological types of HS.
肝肉瘤样癌（HSC）和肝肉瘤（HS）是罕见的恶性肿瘤。在没有病理学检查的情况下，由于这两种肿瘤在临床表现和影像学特征上经常重叠，因此很难进行鉴别诊断。目前，关于HSC和HS的超声（US）、超声造影（CEUS）和计算机断层扫描造影（CECT）特征的分析有限。因此，我们研究的目的是评估US、CEUS和CECT在HSC和HS鉴别诊断中的价值。
2015年至2022年，共有23例HSC患者（n = 11）和HS患者（n = 12）纳入本回顾性研究。我们分析了这些患者的临床、病理和影像学数据。进行差异分析以确定一致和独特的特征。
HSC患者慢性肝炎（p = 0.005）和肝硬化（p = 0.027）的患病率明显高于HS患者，而HS患者转移更为常见（p = 0.005）。HSC的病变大小（8.1±2.2 cm）略大于HS（6.2±3.4 cm）。在传统超声上，HS和HSC的特征相似。在CEUS中，HSC始终表现为不均匀增强模式，而HS，特别是肝血管肉瘤（HA），表现为高增强的患病率更高（75%）。在CECT上，两组所有肿块均表现为低密度。HSC和HS之间在边缘清晰度上观察到统计学显著差异（p = 0.015）。
HSC和HS通常表现为低回声和低血供的肿块。HSC通常表现为不均匀密度。增强程度、洗脱开始时间和坏死区域的存在可能有助于区分HS的不同病理类型。
