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Impact on liver cancer treatment of a first erroneous diagnosis of hemangioma.
- Source :
-
World journal of surgery [World J Surg] 2014 Oct; Vol. 38 (10), pp. 2685-91. - Publication Year :
- 2014
-
Abstract
- Background: Most liver hemangioma (HA) diagnoses are presumptive and based on radiological features and growth trend. The goal of this study was to analyze the impact of a false diagnosis of hemangioma upon the overall therapeutic course and upon the prognosis of a liver malignancy.<br />Methods: Twenty-eight patients with liver cancer who were observed in the period 2001-2007 after an initial erroneous diagnosis of HA were retrospectively evaluated. We studied their radiological workup after blind revision of the images by two radiologists with specific expertise in liver imaging, analyzing the relationship between overall management and center volume, mean delay from the first test to the curative treatment, and clinical consequences of this diagnostic mistake.<br />Results: The diagnosis of false HA occurred in a low-volume center (LVC) in 75 % of cases. A specific risk for liver cancer was present in 71.4 % of patients. US gave a false diagnosis of HA in 25/27 patients, a CT scan in 18/25 patients, and MRI in 6/16 patients. The final diagnosis was reached with a mean delay of 22 months. Liver resection was possible in 22 patients; in the 17 hepatocellular carcinoma cases, the survival rate was 69.4 % at 5 years after the first observation.<br />Conclusions: A false diagnosis of HA in the presence of malignancy is not rare nowadays and significantly reduces the chances of cure. In situations at risk of having the error occur (poor technical quality of imaging, low specific experience, doubtful diagnosis, and high-cancer-risk patient), the rationale approach is to discuss the case with a multidisciplinary team skilled in the field of liver cancer.
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular diagnostic imaging
Carcinoma, Hepatocellular surgery
Female
Hemangioma diagnostic imaging
Hepatectomy
Humans
Liver Neoplasms diagnostic imaging
Liver Neoplasms surgery
Magnetic Resonance Imaging
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Tomography, X-Ray Computed
Tumor Burden
Ultrasonography
Bile Duct Neoplasms diagnosis
Bile Ducts, Intrahepatic
Carcinoma, Hepatocellular diagnosis
Cholangiocarcinoma diagnosis
Delayed Diagnosis
Diagnostic Errors
Hemangioma diagnosis
Liver Neoplasms diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2323
- Volume :
- 38
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- World journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 24870388
- Full Text :
- https://doi.org/10.1007/s00268-014-2643-7