Hepatocellular Carcinoma

  • Irene BargelliniEmail author
  • Laura Coletti
  • Giulia Lorenzoni
Part of the Cancer Dissemination Pathways book series (CDP)


HCC is the third leading cause of cancer-related death worldwide. It is more frequently associated with liver cirrhosis, developing through a long-lasting process of carcinogenesis involving several steps, from regenerative nodules to overt HCC. In cirrhotic patients, HCC can be reliably diagnosed by non-invasive dynamic imaging, when the typical wash-in/wash-out pattern is identified. Besides these radiological hallmarks, several imaging features can be detected indicating different biological aggressiveness and risk of metastasis. The main dissemination pathway for HCC is through the venous circulation causing microvascular and macrovascular invasion, as well as extrahepatic tumour spread. Staging and treatment options are based not only on tumour extension but also on liver function and general clinical conditions. Patients’ prognosis is mainly related to the intrahepatic tumour burden, since mortality is predominantly determined by liver failure secondary to tumour progression. Metastases are relatively infrequent and are indicators of tumour aggressiveness, reducing the chances for cure. The chapter will review main imaging features associated with HCC prognosis and routes of tumour dissemination and discuss treatment options in relation to HCC staging and sites of metastasis.


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Irene Bargellini
    • 1
    Email author
  • Laura Coletti
    • 2
  • Giulia Lorenzoni
    • 1
  1. 1.Department of Interventional RadiologyPisa University HospitalPisaItaly
  2. 2.Department of Liver Surgery and TransplantationPisa University HospitalPisaItaly

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