Clinicopathologic comparison between resected hepatocellular carcinomas (HCC) and recurrent tumors A special reference to multicentric carcinogenesis of HCC

Abstract

Postoperative metachronous multicentric carcinogenesis of hepatocellular carcinoma (HCC) was studied by comparison of the histologic grade of resected and recurrent tumors in 31 cases which underwent ultrasound-guided fine-needle biopsies for the initial recurrent tumors with diameter of less than 20 mm. The criteria that the cases in which recurrent tumors show well-differentiated HCC without regard to the differentiation of resected tumors should be multicentric carcinogenesis, and that the cases in which recurrent tumors show moderate or poorly differentiated HCC with the same or lower degree of differentiation compared with the differentiation of resected tumor was consistent with metastasis, were applied. In 16 (51.6%) out of the 31 cases, multicentric carcinogenesis was thought to occur (multicentric group). In 14 cases, recurrence was thought to be metastasis (metastatic group). The multicentric group tended to have smaller diameters in resected tumors and a high incidence of the association of liver cirrhosis and adenomatous hyperplasia. In gross classification of resected tumors, six cases of all single nodular with perinodular tumor growth type and infiltrative type had metastatic recurrences, and multicentric carcinogenesis was often seen in cases of single nodular type, multinodular type and confluent multinodular type. In the multicentric group, recurrence occurred at every postoperative period as long as 65 months including four cases of early recurrence within 6 months and six cases of late recurrence later than 24 months. On the contrary, in 12 cases in the metastatic group the recurrent interval ranged from 6 to 19 months.