Highlights
- •HCC has high propensity for vascular and locoregional invasion.
- •Patients with invasive disease may not be eligible for curative treatment.
- •Radiologists should be familiar with findings of invasive HCCs.
Abstract
Hepatocellular carcinoma (HCC) is the 5th most common neoplasm and the 3rd leading
cause of cancer related mortality worldwide. Early stages of the neoplasm may be treated
curatively with liver resection or orthotopic liver transplant. However, HCC has a
high propensity for vascular and locoregional invasion, which can preclude these treatment
options. The portal vein is the most invaded structure, while other regional structures
affected include the hepatic vein, inferior vena cava, gallbladder, peritoneum, diaphragm,
and the gastrointestinal tract. Management of invasive and advanced stages of HCC
includes modalities such as transarterial chemoembolization (TACE), transarterial
radioembolization (TARE), and systemic chemotherapy, which are non-curative and focus
on relieving tumor burden and slowing progression. A multimodality imaging approach
is effective in identifying areas of tumor invasion and distinguishing between bland
and tumor thrombi. Due to implications in prognosis and management, it is imperative
for radiologists to accurately identify imaging patterns of regional invasion by HCC
and to distinguish between bland and tumor thrombus in cases of potential vascular
invasion.
Keywords
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Article info
Publication history
Published online: March 03, 2023
Accepted:
March 1,
2023
Received in revised form:
February 25,
2023
Received:
September 27,
2022
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
