Hepatocellular carcinoma associated with schistosomiasis japonica

One-hundred and fourteen cases of hepatocellular carcinoma (HCC) which underwent computed tomography (CT) and angiography at the University Hospital of Yamanashi were reviewed. These included 24 cases of HCC associated with hepatic schistosomiasis japonica. Compared with the other cases, radiological features of HCC with schistosomiasis japonica were clarified. Patients with multinodular HCC were most common (13/24), followed by those with single nodular HCC (7/24), while those with massive or diffuse HCC were few (4/24). In patients with marked CT changes (grade III or IV) of hepatic schistosomiasis japonica, most of HCC nodules were disclosed as a mass with homogenous hypodensity surrounded by 'shell-like calcifications'. Obstruction of the portal vein or its branches due to tumor thrombus was rarely noted (4/24). These features are presumably attributed to periportal fibrosis which is characateristic of hepatic schistosomiasis japonica. Because of these features, it is expected that hepatocellular carciniomas with schistosomiasis japonica can be treated by transcatheter arterial embolization more effectively than those without schistosomiasis japonica. (author)