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Review
. 2022 May 5:9:379-387.
doi: 10.2147/JHC.S364742. eCollection 2022.

Macrotrabecular-Massive Hepatocellular Carcinoma: What Should We Know?

Xiaoming Li #  1   2 , Qiandong Yao #  3 , Chen Liu #  1 , Jian Wang  1 , Huarong Zhang  4 , Shiguang Li  2   5 , Ping Cai  1
Affiliations
Review

Macrotrabecular-Massive Hepatocellular Carcinoma: What Should We Know?

Xiaoming Li et al. J Hepatocell Carcinoma. .

Abstract

Hepatocellular carcinoma is one of the most common malignancies globally. Recently, a newly identified histological subtype, designated as "macrotrabecular-massive hepatocellular carcinoma" (MTM-HCC), has been associated with an aggressive phenotype and has received extensive attention. MTM-HCC was a strong independent prognostic predictor of early and overall recurrence because it is closely related to tumor molecular subclass, gene mutation, carcinogenesis pathways, and immunohistochemical markers. In addition, preoperative imaging examination can potentially provide an essential clue for diagnosing MTM-HCC, intratumor necrosis or ischemia is an independent predictor for MTM-HCC on Gd-EOB-DTPA enhanced MRI or CT. Early diagnosis and appropriate treatment of MTM-HCC could prove beneficial for preventing early recurrence and could improve outcomes.

Keywords: gene mutation; hepatocellular carcinoma; macrotrabecular-massive; magnetic resonance imaging; molecular subclass.

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Conflict of interest statement

The authors declare that they have no competing interests in this work.

Figures

Figure 1
Figure 1
Integration of HCC clinical features, pathological features, molecular subclass, carcinogenic pathway, and gene mutation.
Figure 2
Figure 2
Macrotrabecular-massive HCC. The tumor center showed no enhancement area (white arrow) in the arterial phase (A) and portal phase (B) on contrast-enhanced CT, representing necrosis. Necrosis (white arrow) appears as hypo-enhancement in arterial phase (C) and portal phase (D) on MRI. Neoplastic cells of MTM-HCC showed trabecular architecture (White arrow) at pathological (HES, x100) (E). Numerous necrotic foci (white arrow) were observed in this case (HES, x200) (F).
Figure 3
Figure 3
Macrotrabecular-massive HCC. The tumor showed markedly hypo- or no enhancement area (White arrow) in the arterial phase (A) and portal phase (B) on contrast-enhanced CT, representing ischemia or necrosis. Ischemia or necrosis (White arrow) appears as hypo- or no enhancement in arterial phase (C) and portal phase (D) on MRI. Neoplastic cells of MTM-HCC showed trabecular architecture (White arrow) and Obvious necrosis (Black arrow) (HES, x100) (E) Trabecular architecture (White arrow) and numerous necrotic foci (White arrow) were observed in this case (HES, x200) (F).
See this image and copyright information in PMC

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