Frequency of Tumor Entities among Liver Tumors of Unclear Etiology Initially Detected by Sonography in the Noncirrhotic or Cirrhotic Livers of 1349 Patients

K. Seitz; C. Greis; A. Schuler; T. Bernatik; W. Blank; C. F. Dietrich; D. Strobel

doi:10.1055/s-0031-1281858

Ultraschall in der Medizin - European Journal of Ultrasound, Table of Contents

Ultraschall Med 2011; 32(06): 598-603
DOI: 10.1055/s-0031-1281858

Original Article

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 StudyHäufigkeitsverteilung der Tumorentitäten primär sonografisch detektierter Tumore ungeklärter Aetiologie in nicht zirrhotischer und zirrhotischer Leber bei 1349 PatientenResultate der DEGUM-Multicenterstudie

K. Seitz

¹Department of Internal Medicine, KKH Sigmaringen

,

C. Greis

²Department of Clinical Research, Bracco, Konstanz

,

A. Schuler

³Department of Internal Medicine, Helfenstein Klinik Geislingen

,

T. Bernatik

⁶Department of Medicine I, University of Erlangen

,

W. Blank

⁴Department of Internal Medicine, Klinikum am Steinenberg Reutlingen

,

C. F. Dietrich

⁵Department of Internal Medicine, Caritas-Krankenhaus Bad Mergentheim

,

D. Strobel

⁶Department of Medicine I, University of Erlangen

› Author Affiliations

Abstract

Zusammenfassung

Ziel: Untersuchung der Häufigkeit von verschiedenen soliden fokalen Leberläsionen (SFLL) in nicht zirrhotischen und zirrhotischen Lebern unter besonderer Berücksichtigung der Häufigkeit der Metastasierung in Zirrhoselebern.

Material und Methoden: Das Patientenkollektiv der DEGUM-Multicenterstudie (n = 1349) wurde reevaluiert und in ein Subkollektiv A ohne (n = 1067) und B mit Zirrhose (n = 282) unterteilt. Die verschiedenen Tumorentitäten waren zu 74,6 % histologisch gesichert (n = 1006).

Ergebnisse: Im Subkollektiv A fanden sich 385 Fälle mit Metastasen (36,4 %) und 65 mit HCC (6,1 %), demgegenüber waren an benignen Läsionen Hämangiome mit 237 Fällen (22,4 %) und FNH mit 170 Fällen (16,1 %) am häufigsten. Im Subkollektiv B fanden sich 216 Fälle von HCC (76,6 %) und 12 Metastasen (4,3 %), sowie 42 benigne Läsionen (14,9 %). CCC waren im Subkollektiv A (3,3 %) und im Subkollektiv B (2,5 %) selten. Eine Tumoranamnese erhöht die Wahrscheinlichkeit für eine maligne SFLL im Subkollektiv A 1,8-fach, nicht jedoch im Subkollektiv B.

Schlussfolgerung: Die Häufigkeit der verschieden Tumorentitäten unterscheidet sich bei Patienten mit und ohne Zirrhose grundlegend. In nicht zirrhotischen Lebern sind maligne und benigne SFLL etwa gleich häufig. Im Vordergrund stehen Metastasen, Hämangiome und FNH, CCC sind selten. Eine Tumorvorgeschichte erhöht die Wahrscheinlichkeit auf eine maligne SFLL. Bei Zirrhose dominieren HCC, HCC sind 18-mal häufiger als Metastasen. Benigne SFLL und CCC sind selten

Abstract

Aim: Investigation of the frequency of various solid focal liver lesions (SFLL) in noncirrhotic and cirrhotic livers with focus on the frequency of metastasis in cirrhotic livers.

Material and Methods: The patient collective in the DEGUM multicenter study (n = 1349) was reevaluated and divided in subcollective A without (n = 1067) and B with cirrhosis (n = 282). 74.6 % of the various tumor entities were confirmed histologically (n = 1006).

Results: In subcollective A there were 385 patients with metastases (36.4 %) and 65 with HCC (6.1 %), whereas the most common benign lesions were hemangioma, with 237 cases (22.4 %) and FNH, with 170 cases (16.1 %). In subcollective B there were 216 cases of HCC (76.6 %) and 12 metastases (4.3 %), as well as 42 benign lesions (14.9 %). CCC was rare in both subcollective A (3.3 %) and subcollective B (2.5 %). A positive oncological history increased the probability of a malignant SFLL in subcollective A by 1.8 times, but did not do so in subcollective B.

Conclusion: The frequency of various tumor entities is different in patients with and without cirrhosis of the liver. In noncirrhotic livers, malignant and benign SFLL are equally common. The most common forms are metastases, hemangiomas and FNH, CCC is rare. A positive history of extrahepatic malignancy increases the probability of a malignant SFLL. In cirrhosis, HCC dominates, HCC is 18 times as common as metastases. Benign SFLL and CCC are rare.

Key words

liver tumor - tumor entitiy - metastasis - HCC - liver cirrhosis - ultrasound (US) - CEUS - focal liver lesion, - DEGUM-Multicenter-Trial

Full Text

References

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