State-of-the-art MR Imaging of Uncommon Hepatocellular Tumours: Fibrolamellar Hepatocellular Carcinoma and Combined Hepatocellularcholangiocarcinoma

Page: [269 - 280] Pages: 12

  • * (Excluding Mailing and Handling)

Abstract

Background: Fibrolamellar Carcinoma (FLC) and Combined Hepatocellular- Cholangiocarcinoma (CHC) are rare primary liver tumours, which are related to different clinical settings. In both tumours, correlation with clinical data and laboratory tests are extremely important.

Discussion: Typically, FLC is diagnosed in young patients without any chronic disease and with normal biochemical tests, whereas CHC arises in cirrhotic patients with elevated tumour markers: AFP and/or CA 19-9.

The review describes epidemiology, aetiology, pathogenesis, radiological features and treatment of these tumours.

Imaging features typical for FLC are: The presence of central scar, calcifications, the large size, heterogeneous and early contrast-enhancement.

Conclusion: The diagnosis of CHC may be suggested in case of elevation of both AFP and CA 19- 9 or inconsistency between elevated tumour markers and imaging findings (i.e., elevated CA 19-9 and radiological features of HCC, or elevated AFP with imaging findings characteristic of ICC).

Keywords: Fibrolamellar carcinoma, combined hepatocellular-cholangiocarcinoma, primary hepatic tumors, hepatobiliary contrast agents, computed tomography, magnetic resonance imaging.

Graphical Abstract

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