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Japanese Journal of Clinical Oncology 21:366-371 (1991)
© 1991 Foundation for Promotion of Cancer Research

research-article

Spontaneous Massive Hemorrhage within a Malignant Tumor of the Liver: Diagnostic Features in Sonography and CT

Kazunori Aoki1,*, Kenichi Takayasu1, Yukio Muramatsu1, Noriyuki Moriyama1, Yasunori Mizuguchi1, Michiie Sakamoto2 and Setsuo Hirohashi2

1Department of Diagnostic Radiology, National Cancer Center Hospital 1-1, Tsukiji 5-chome, Chuo-ku, Tokyo 104
2Pathology Division, National Cancer Center Research Institute 1-1, Tsukiji 5-chome, Chuo-ku, Tokyo 104

*For reprints and all correspondence

Received March 14, 1991; accepted May 9, 1991

Computed tomography (CT) and sonography performed on four patients with histopathologically proven massive intratumoral hemorrhages in the liver were compared with pathological findings. Unenhanced CT showed a round low-density mass, and enhanced CT produced slight enhancements in the peripheral portions of the masses in two patients which corresponded to histopathologically viable cancerous portions. In contrast, sonography showed multilocular cystic masses with variously shaped septa, assuming a honeycomb appearance. Histopathologically, the septa were made up of blood clots with or without granulation tissue, scar and viable tumor, and the cystic spaces were filled with exudate and erythrocytes. Combined study by CT and sonography could be useful in differentiating massive hemorrhagic malignancies from cystic and necrotic masses and/or simple hemorrhagic lesions. The danger of malignant tumors with massive hemorrhage possibly being diagnosed as benign lesions, such as hematomas and abscesses, is also stressed.

Key Words: Liver neoplasms • Liver hemorrhage • Computed tomography • Sonography


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