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Precis Future Med > Epub ahead of print
DOI: https://doi.org/10.23838/pfm.2021.00086    [Epub ahead of print]
Published online August 27, 2021.
Infiltrative invasion of the diaphragm: an uncommon manifestation of recurrent hepatocellular carcinoma
Chu Hyun Kim1  , Kyoung Doo Song1  , Jung Han Woo2 
1Department of Radiology and CenterforImaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Radiology, Seoul District Hospital, Seoul, Korea
Correspondence  Kyoung Doo Song ,Tel: +82-2-3410-2519, Email: kd3893.song@samsung.com
Submitted: July 6, 2021  Accepted after revision: July 27, 2021
Abstract
Purpose
To report on infiltrative invasion of the diaphragm, an uncommon manifestation ofrecurrent hepatocellular carcinoma (HCC), and evaluate its clinical significance.
Methods
Using the term “diaphragm” or “diaphragmatic” and “invasion” or “involvement,” we searched for patients in the database of radiologic reports of liver computed tomography or magnetic resonance imaging performed between 2012 and 2016 at our institution. Nine patients with infiltrative invasion of the diaphragm due to recurrent HCC were included. Their clinical and imaging findings were evaluated.
Results
The median age of patients at the time of diagnosis was 68 years (range, 40 to 73). There were eight men and one woman. Imaging findings of infiltrative invasion of the diaphragm revealed diffuse thickening with enhancementinvolving a part ofthe diaphragm. The median interval between initial manifestation on imaging and radiologic diagnosis of infiltrative invasion ofthe diaphragm was 6.8 months (range, 3.4 to 18.6). In two of three patients who underwent surgicalresection, tumors of the diaphragm were controlled without recurrence. In six patients except for one patient who was not followed up, tumors recurred at the resection site or diaphragm tumors showed a partial response or disease progression.
Conclusion
Infiltrative invasion of the diaphragm by recurrent HCC manifested with diffuse thickening and diaphragm enhancement on radiologic imaging. A good prognosis can be expected only in patients who are diagnosed early and undergo surgical resection.
Keywords: Carcinoma, hepatocellular; Diaphragm; Recurrence
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