Hepatic pseudolesions adjacent to the falciform ligament
Authors:
P. Vávra 1,2,6; M. Vávrová 3; P. Delongová 4; T. Jonszta 5; J. Dvořáčková 4; A. Pelikán 1,2; M. Penhaker 6; J. Nowaková 6; M. Peteja 1,2; P. Zonča 1,2
Authors‘ workplace:
Katedra chirurgických oborů, LF Ostravské univerzity
vedoucí katedry: doc. MUDr. P. Vávra, Ph. D.
1; Chirurgická klinika, FN Ostrava
přednosta: doc. MUDr. P. Zonča, Ph. D., FRCS
2; Oddělení radiologie a zobrazovacích metod, Nemocnice Nový Jíčín, a. s.
primář: MUDr. M. Velkoborský
3; Ústav patologie, LF Ostravské univerzity a FN Ostrava
přednosta: doc. MUDr. J. Dvořáčková, Ph. D.
4; Ústav zobrazovacích metod, LF Ostravské univerzity a FN Ostrava
přednosta: doc. MUDr. P. Krupa, CSc.
5; Fakulta elektrotechniky a informatiky, VŠB – Technická univerzita Ostrava
děkan: prof. RNDr. V. Snášel, CSc.
6
Published in:
Rozhl. Chir., 2015, roč. 94, č. 11, s. 449-453.
Category:
Review
Overview
Introduction:
Accurate detection of hepatic pseudolesions using multi-detector CT and MRI examinations is crucial for the differentiation of benign alterations from primary and secondary malignant lesions in hepatic parenchyma.
Method:
The authors conducted a systematic literature review in PubMed. “Liver“ and “pseudolesion“ were used as keywords in English and Czech, and papers/articles published from 2000 to 2014 were retrieved.
Results:
The authors presented a literature review. In addition, the authors performed a retrospective evaluation of a group of patients treated for liver disease at University Hospital Ostrava where this anomaly was encountered in 7 cases.
In 3 of the patients, diagnostic laparoscopy was done, with visual examination of the lesion accompanied by intraoperative ultrasound exam (IOUS) and partial excision, to establish the diagnosis. Subsequent histological assessment of the specimens confirmed the diagnosis of a steatotic lesion in each of these 3 patients. Additional 2 of the 7 patients underwent liver surgery for concurrent metastatic lesions of colorectal cancer and an open-access revision of the suspected lesions was performed. Visual inspection and intraoperative ultrasound (IOUS) was followed by excisional biopsy. The histology revealed macro- and micro-vesicular steatosis and excluded malignant changes. The last 2 patients still continue to be followed–up regularly on a 6-month routine check-up basis at our hepatology unit.
Conclusion:
The authors presented their own experience gained through inter-disciplinary cooperation at Multidisciplinary conferences. A literature overview of this unusual subject is also included. Particularly in oncologic patients, correct interpretation of these pseudolesions may help to avoid unnecessary biopsies, further imaging examinations and diagnostic laparoscopies and/or explorative laparotomies.
Key words:
pseudolesion − hepatic neoplasm − resection
Sources
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10. Vavra P, Dostalik J, Zacharoulis D, et al. Initial clinical results of a new bipolar radiofrequency ablation device. Conference: International Surgical Congress of the Association-of-Surgeons-in Great-Britain-and-IrelandLocation: Bournemouth, England 2008;52:355−8.
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12. Vávra P, Ihnát P, Vávrová M, et al. Hand-assisted laparoscopic liver resection using Habib´s technique: early experience. Wideochir Inne Tech Malo Inwazyjne 2012;7:8−12.
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2015 Issue 11
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