Download PDF
Z Gastroenterol 2022; 60(04): 586-592
DOI: 10.1055/a-1649-8857
Originalarbeit

Frequency of synchronous malignant liver lesions initially detected by ultrasound in patients with newly diagnosed underlying non-hematologic malignant disease: a retrospective study in 434 patients

Häufigkeit von synchronen malignen Leberläsionen detektiert im Ultraschall bei Patienten mit neu diagnostizierter nicht-hämatologischer maligner Erkrankung: eine retrospektive Studie bei 434 Patienten
Ehsan Safai Zadeh  ‡
1   Interdisciplinary Center of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
,
Martin Axel Baumgarten‡
1   Interdisciplinary Center of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
,
Christoph F. Dietrich 
2   Department Allgemeine Innere Medizin (DAIM), Beau Site, Salem und Permanence, Bern, Kliniken Hirslanden Bern, Bern, Switzerland
,
Christian Görg
1   Interdisciplinary Center of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
3   Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg/ Lahn, Germany
,
Albrecht Neesse
4   Gastroenterology,Gastrointestinal Oncology and Endocrinology, University Medicine Goettingen, Göttingen, Germany
,
Corinna Trenker 
5   Haematology, Oncology and Immunology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg, Germany
,
Amjad Alhyari 
3   Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipps University Marburg, Marburg/ Lahn, Germany
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Introduction This study described the frequency of malignant synchronous focal liver lesions (FLLs) in patients with newly diagnosed non-hematologic malignant disease.

Methods From June 2013 to January 2017, 434 patients with synchronous FLLs and newly diagnosed underlying malignant disease were included in the study. The diagnosis of the FLLs was made by histology and/or contrast-enhanced imaging. The final medical report was used for analysis in the study.

Results Of the 434 liver lesions, 258 (59.4%) were malignant and 176 (40.6%) benign. All malignant lesions were metastases. The benign liver lesions were comprised of 93 cysts (21.4%), 52 hemangiomas (12.0%), 20 focal fatty sparing (4.6%), 4 focal nodular hyperplasia (0.9%), 3 unspecified benign lesions (0.7%), 2 regenerative nodules (0.5%), 1 calcification (0.2%), and 1 adenoma (0.2%). Diseases with the highest percentage frequency of synchronous malignant FLLs were cholangiocarcinoma with 86.7%, neuroendocrine tumor with 72.7%, and pancreatic carcinoma with 72.0%. Gastric carcinoma (33.3%), breast carcinoma (44.4%), and urothelial cell carcinoma (45.5%) were the diseases with the lowest percentage frequency of synchronous malignant FLLs.

Conclusion In total, the frequency of malignant synchronous FLLs in newly diagnosed non-hematologic malignant disease was 59.4%. In particular, cholangiocarcinoma, neuroendocrine tumor, and pancreatic carcinoma were the diseases with the highest rate of synchronous malignant FLLs.

Zusammenfassung

Ziel Beschreibung der Häufigkeit maligner synchroner fokaler Leberläsionen (FLLs) bei Patienten mit neu diagnostizierter nichthämatologischer maligner Erkrankung.

Material und Methoden Von Juni 2013 bis Januar 2017 wurden 434 konsekutive Patienten mit synchronen FLLs und neu diagnostizierter maligner Grunderkrankung in die Studie eingeschlossen. Die Diagnose der FLLs wurde durch Histologie und/oder Kontrastmittelbildgebung gestellt. Der finale Arztbrief wurde für die Analyse in der Studie verwendet.

Ergebnisse Von den 434 Leberläsionen waren 258 (59,4%) maligne und 176 (40,6%) benigne. Alle bösartigen Läsionen waren Metastasen. Bei den gutartigen Leberläsionen handelte es sich um 93 Zysten (21,4 %), 52 Hämangiome (12,0 %), 20 fokale Fettverteilungsstörung (4,6 %), 4 fokale noduläre Hyperplasien (0,9 %), 3 nicht näher spezifizierte gutartige Läsionen (0,7 %), 2 regenerative Knötchen (0,5 %), 1 Verkalkung (0,2 %) und 1 Adenom (0,2 %). Erkrankungen mit der höchsten prozentualen Häufigkeit von synchronen malignen FLLs waren das cholangiozelluläre Karzinom mit 86,7%, der neuroendokrine Tumor mit 72,7% und das Pankreaskarzinom mit 72,0%. Magenkarzinom (33,3%), Mammakarzinom (44,4%) und Urothelzellkarzinom (45,5%) waren die Erkrankungen mit der geringsten prozentualen Häufigkeit synchroner maligner FLLs.

Schlussfolgerung Insgesamt betrug die absolute Häufigkeit von malignen synchronen FLLs bei neu diagnostizierten nichthämatologischen malignen Erkrankungen 59,4 %. Insbesondere cholangiozelluläre Karzinome, NETs und das Pankreaskarzinom zeigten die höchste Rate an malignen synchronen fokalen Leberläsionen.

Schlüsselwörter

nicht-hämatologische maligne Erkrankung - seed and soil - Tumorentität - fokale Leberläsionen - Ultraschall

Keywords

non-hematologic malignant disease - seed and soil - tumor entity - focal liver lesions - ultrasound


Publication History

Received: 20 May 2021

Accepted after revision: 14 September 2021

Article published online:
20 October 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Kaltenbach TE-M, Engler P, Kratzer W. et al. Prevalence of benign focal liver lesions: ultrasound investigation of 45,319 hospital patients. Abdom Radiol 2016; 41: 25-32
    CrossrefPubMedSearch in Google Scholar
  • 2 Dietrich CF. Fortuitously discovered liver lesions. World J Gastroenterol 2013; 19: 3173
    CrossrefPubMedSearch in Google Scholar
  • 3 Claudon M, Dietrich C, Choi B. et al. Guidelines and Good Clinical Practice Recommendations for Contrast-Enhanced Ultrasound (CEUS) in the Liver – Update 2012. Ultraschall Med 2012; 34: 11-29
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Lantinga MA. Evaluation of hepatic cystic lesions. World J Gastroenterol 2013; 19: 3543
    CrossrefPubMedSearch in Google Scholar
  • 5 Friedrich-Rust M, Klopffleisch T, Nierhoff J. et al. Contrast-enhanced ultrasound for the differentiation of benign and malignant focal liver lesions: a meta-analysis. Liver Int 2013; 33: 739-755
    CrossrefPubMedSearch in Google Scholar
  • 6 Dong Y, Wang WP, Mao F. et al. Imaging features of fibrolamellar hepatocellular carcinoma with contrast-enhanced ultrasound. Ultraschall Med 2021; 42: 306-313
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 Dietrich CF, Nolsøe CP, Barr RG. et al. Guidelines and Good Clinical Practice Recommendations for Contrast-Enhanced Ultrasound (CEUS) in the Liver – Update 2020 WFUMB in cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS. Ultrasound Med Biol 2020; 46: 2579-2604
    CrossrefPubMedSearch in Google Scholar
  • 8 Dietrich CF, Nolsøe CP, Barr RG. et al. Guidelines and Good Clinical Practice Recommendations for Contrast-Enhanced Ultrasound (CEUS) in the Liver – Update 2020 WFUMB in cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS. Ultraschall Med 2020; 41: 562-585
    Thieme ConnectPubMedSearch in Google Scholar
  • 9 Fares J, Fares MY, Khachfe HH. et al. Molecular principles of metastasis: a hallmark of cancer revisited. Signal Transduct Target Ther 2020; 5: 28
    CrossrefPubMedSearch in Google Scholar
  • 10 Obenauf AC, Massagué J. Surviving at a distance: organ-specific metastasis. Trends Cancer 2015; 1: 76-91
    Search in Google Scholar
  • 11 Paget S. The distribution of secondary growths in cancer of the breast. Lancet 1889; 133: 571-573
    CrossrefPubMedSearch in Google Scholar
  • 12 Langley RR, Fidler IJ. The seed and soil hypothesis revisited—the role of tumor-stroma interactions in metastasis to different organs. Int J Cancer 2011; 128: 2527-2535
    CrossrefPubMedSearch in Google Scholar
  • 13 Minn AJ, Kang Y, Serganova I. et al. Distinct organ-specific metastatic potential of individual breast cancer cells and primary tumors. J Clin Investig 2005; 115: 44-55
    CrossrefPubMedSearch in Google Scholar
  • 14 Akhtar M, Haider A, Rashid S. et al. Paget’s “seed and soil” theory of cancer metastasis: an idea whose time has come. Adv Anat Pathol 2019; 26: 69-74
    CrossrefPubMedSearch in Google Scholar
  • 15 Rees M, Tekkis PP, Welsh FK. et al. Evaluation of long-term survival after hepatic resection for metastatic colorectal cancer: a multifactorial model of 929 patients. Ann Surg 2008; 247: 125-135
    CrossrefPubMedSearch in Google Scholar
  • 16 Heese F, Görg C. Diagnostische Wertigkeit einer internistischen Referenzsonographie (DEGUM-Stufe 3). Ultraschall Med 2006; 27: 220-224
    Thieme ConnectPubMedSearch in Google Scholar
  • 17 Seitz K, Greis C, Schuler A. et al. Frequency of tumor entities among liver tumors of unclear etiology initially detected by sonography in the noncirrhotic or cirrhotic livers of 1349 patients. Results of the DEGUM multicenter study. Ultraschall Med 2011; 32: 598-603
    Thieme ConnectPubMedSearch in Google Scholar
  • 18 Choi SH, Kwon HJ, Lee SY. et al. Focal hepatic solid lesions incidentally detected on initial ultrasonography in 542 asymptomatic patients. Abdom Radiol 2016; 41: 265-272
    CrossrefPubMedSearch in Google Scholar
  • 19 Heller E, Görg C. Focal liver lesions in patients with malignant haematological disease: value of B-mode ultrasound in comparison to contrast-enhanced ultrasound—a retrospective study with N = 61 patients. Z Gastroenterol 2013; 51: 558-567
    Thieme ConnectPubMedSearch in Google Scholar
  • 20 Hoshino A, Costa-Silva B, Shen T-L. et al. Tumour exosome integrins determine organotropic metastasis. Nature 2015; 527: 329-335
    CrossrefPubMedSearch in Google Scholar
  • 21 Oronsky B, Ma PC, Morgensztern D. et al. Nothing but NET: a review of neuroendocrine tumors and carcinomas. Neoplasia 2017; 19: 991-1002
    CrossrefPubMedSearch in Google Scholar
  • 22 Takeda Y, Saiura A, Takahashi Y. et al. Asymptomatic pancreatic cancer: does incidental detection impact long-term outcomes?. J Gastrointest Surg 2017; 21: 1287-1295
    CrossrefPubMedSearch in Google Scholar