Hepatocellular carcinoma: incidental finding in cirrhotic explanted livers

Area of Science:

• Hepatology
• Oncology
• Pathology

Background:

• Cirrhosis significantly increases the risk of hepatocellular carcinoma (HCC).
• Early detection of neoplastic nodules in cirrhotic patients is vital for effective management.
• Morphological study of explanted livers can reveal lesions missed by preoperative imaging.

Purpose of the Study:

• To determine the incidence of incidentally discovered hepatocellular carcinoma (HCC) in explanted cirrhotic livers.
• To characterize the features of HCC found incidentally during pathological evaluation.

Main Methods:

• Analysis of 30 explanted cirrhotic livers with diagnosed HCC.
• Detailed sectioning of livers and microscopic examination of nodules.
• Retrospective review of clinical records and comparison with imaging data.

Main Results:

• Hepatocellular carcinoma (HCC) was incidentally found in 63.3% of explanted cirrhotic livers.
• Incidental HCC lesions ranged from microscopic to 2 cm, with single or multiple nodules.
• Imaging methods underestimated the number of HCC lesions in a significant proportion of patients.

Conclusions:

• Imaging may underestimate the prevalence and number of hepatocellular carcinoma (HCC) in cirrhotic livers.
• Histological examination of explanted livers is essential for detecting small, multifocal, and incidental HCC.
• Findings highlight the multifocal nature of hepatic carcinogenesis and the need for correlation with patient outcomes.