J Korean Soc Radiol.  2011 Oct;65(4):399-402. 10.3348/jksr.2011.65.4.399.

Magnetic Resonance Imaging Finding of Metastatic Hepatocellular Carcinoma in Ovary: A Case Report

• Kwak SH
• Cho BS
• Kang MH
• Lee SY
• Han GS
• Cha SH
• Park KS
• Kim SJ
• Choi SY

• KMID: 2002942
• DOI: http://doi.org/10.3348/jksr.2011.65.4.399

Abstract

Hepatocellular carcinoma is the most common primary malignant tumor of liver. Metastasis of hepatocellular carcinoma occurs in various organs, but metastasis to the ovary is extremely rare. We report MRI finding of metastatic hepatocellular carcinoma of the ovary in a 37-year-old woman who was treated hepatocellular carcinoma transarterial chemoembolization and radiofrequency ablation a year ago. Pelvic MRI revealed a mass in pelvic cavity with heterogeneous signal intensity and centripetal enhancement. Surgical excision and pathologic examination confirmed metastatic hepatocellular carcinoma in the ovary.

MeSH Terms

Adult
Carcinoma, Hepatocellular
Female
Humans
Liver
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Neoplasm Metastasis
Ovary

Figure

• 

  Fig. 1 A. Transvaginal USG image shows a huge heterogeneous echoic mass in pelvic cavity. B, C, D. MRI reveals 11 cm-sized mass in pelvic cavity. Mass shows diffuse low signal intensity on T1 weighted image (B), and heterogeneous high signal intensity on T2 weighted image (C). Contrast enhanced T1 weighted image (D) shows heterogeneous peripheral enhancement (arrow). Note the nonenhancing central portion on contrast enhanced T1 weighted image and heterogeneous high signal intensity on T2 weighted image, suggesting necrosis (arrowhead). E, F. T1 weighted dynamic contrast enhancement images of 1 minute (E) and 5 minutes (F) shows centripetal enhancement (arrow). Note the nonenhancing low signal intensity at central portion of the mass suggesting necrosis. G. Diffuse and trabecular growth pattern of tumor cells with abundant cytoplasm and pleomorphic nuclei is shown (H&E stain, × 400). H. Immunohistochemical stain for AFP reveals positive reaction in cytoplasm of tumor cells (arrow) (Immunostain for AFP, × 400). Note.-AFP = a-fetoprotein, USG = ultrasonography

Reference

1. Ros PR, Erturk SM. Malignant tumors of the liver. In : Gore RM, Levine MS, editors. Text book of gastrointestinal radiology. 3rd ed. Philadelphia: Saunders;2008. p. 1624–1633.

2. Korean society of abdominal radiology. Abdominal radiology. 2nd ed. Seoul: Ilchokak;2010. p. 337–352.

3. Katyal S, Oliver JH 3rd, Peterson MS, Ferris JV, Carr BS, Baron RL. Extrahepatic metastases of hepatocellular carcinoma. Radiology. 2000; 216:698–703.

4. Kim TH, Cheung DY, Chung WB, Son DK, Jo DH, Chung JS, et al. A case of metastatic hepatocellular carcinoma of the ovary. Korean J Gastroenterol. 2004; 43:215–218.

5. Kim MJ. A case of metastatic hepatocellular carcinoma of the ovary: an immunohistochemical study and literature review. Korean J Pathol. 2005; 39:287–290.

6. Park JH, Han CD, Huh CK, Park JJ, Kim HG, Jung KJ, et al. Hepatocellular carcinoma metastatic to the ovary: one case report and review literature. Korean J Obstet Gynecol. 2001; 44:1900–1904.

7. de Groot ME, Dukel L, Chadha-Ajwani S, Metselaar HJ, Tilanus HW, Huikeshoven FJ. Massive solitary metastasis of hepatocellular carcinoma in the ovary two years after liver transplantation. Eur J Obstet Gynecol Reprod Biol. 2000; 90:109–111.