HCC has 3 growth patterns: solitary lesion, multifocal or multinodular pattern and the diffuse type [1]. Diffuse-type HCC has been considered as an extensive and infiltrative tumor with ill defined margins, frequently accompanied by portal venous tumor thrombosis and high level of serum α-fetoprotein (AFP) [3,4,5,6]. Clinical and pathological findings of diffuse-type HCC were described by Okuda et al [4] in 1981 in six patients. Clinical features were characterized by rapid deterioration of the patient’s general condition, with hepatic failure, fast enlargement of the liver...

Patients: A retrospectively active search was carried out in the radiologic and clinical databases of Ribeirão Preto University Hospital, a regional reference Hospital for 1.000.000 inhabitants, from January 2001 to September 2009, looking for diffuse HCCs, based on imaging criteria. Twenty-six out of 180 patients with diagnosed HCC (14.4%) met the criteria for diffuse-type HCC (21 men (80.7%) and 5 women (19.3%); mean age of 55 +/- 11.8 years, ranging from 18 to 72 years). Imaging criteria – modified from Kanematsu et al [3]: 1)...

All patients presented with chronic liver disease, which etiologic distribution is shown in figures 1 and 2.Fifty percent only of the patients were included in the screening program for HCC detection, based on ultrasound and AFP dosages in intervals of 4 to 6 months.Ultrasound has missed infiltrative HCC detection in 10/20 patients (50%) while CT has missed in 2/20 patients (10%). All 18 patients studied by MRI were diagnosed for infiltrative HCC.Four patients were classified as small infiltrative diffuse-type HCC, which represented 15.3% of diffuse-type...

1. Diffuse-type HCC imaging, clinical and laboratory findings in our study were similar to those described in the literature [1,3]. 2. Despite the fact that ultrasound is the method used in the majority of HCC screening programs, its accuracy for the diffuse-type HCC is lower when compared with published data on solitary and multifocal HCC types [7]. This can lead to a delayed diagnosis and worse prognosis. 3. Identification of vascularized expansive portal vein thrombosis in patients with diffuse liver disease with no defined hepatic...

1. Semelka RC, Voultsinos V, Altun E, Elias Junior, J. MRI of Focal Lesions in Normal and Chronically Diseased Liver. In: Vincent B. Ho; Mark J. Kransdorf; Caroline Reinhold. (Org.). Body MRI - Categorical Course Syllabus. Leesburg, VA: American Roentgen Ray Society, 2006, v. , p. 11-38. 2. Franca AV, Elias Junior J, Lima BL, Martinelli AL, Carrilho FJ. Diagnosis, staging and treatment of hepatocellular carcinoma. Braz J Med Biol Res 2004; 37:1689-1705. 3. Kanematsu M, Semelka RC, Leonardou P, Mastropasqua M, Lee JK. Hepatocellular...

Jorge Elias Jr, MD, PhD.Assistant Radiology ProfessorHead of Imaging Center of School of Medicine of Ribeirao Preto - University of Sao [email protected] de Andrade Hernandes, MD.Radiology [email protected] de Ciências das Imagens e Física MédicaHospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São PauloAv. Bandeirantes, 3.900 - Campus Universitário - Monte Alegre - 14.048-900 - Ribeirão Preto - SP - Brazil