Sclerosing hepatocellular carcinoma: radiologic findings

The radiologic findings of seven patients with sclerosing hepatocellular carcinoma (HCC), an unusual subtype of HCC, were evaluated. Computed tomography (CT) demonstrated a hypointense mass with marked delayed contrast enhancement. Although the tumor was well-defined, the tumor capsule was not seen. Focal atrophy was seen in four patients. Ultrasound (US) showed an isoechoic to hyperechoic mass without a rim. Angiography revealed prominent tumor vessels and prolonged stains in all cases. Arterial encasement was seen in four patients. On magnetic resonance (MR) imaging, all tumors were hypointense on T1-weighted images and hyperintense on T2-weighted images. On dynamic MR study, remarkable contrast enhancement, which continued to the delayed phase, seemed to be characteristic for sclerosing HCC. In the presence of liver tumors with homogeneous architecture, hypervascularity, prolonged enhancement, absence of tumor capsule, and focal atrophy in high-risk patients of HCC, sclerosing HCC should be considered.