preprint · medRxiv
A study conducted at Muhimbili National Hospital examined computed tomography patterns of hepatocellular carcinoma in Tanzanian patients with and without liver cirrhosis. Analysing 73 cases, researchers found that the disease presents at a relatively young median age, around 40 years for patients with cirrhosis and 38 years for those without, with a notable male predominance in both groups. Hepatitis B represented the most common risk factor, affecting over half of the cohort, while right upper quadrant abdominal pain was the primary symptom. Imaging revealed distinct radiological characteristics between the two groups. Cirrhotic patients typically exhibited multifocal, ill-defined tumours that preferentially affected liver segments two, three, and four. In contrast, patients without underlying cirrhosis predominantly presented with solitary, well-defined tumours. These findings show that hepatocellular carcinoma in this population appears at an earlier age than observed in North America, Europe, and Asia.
Liver cancer is a major global health challenge that often behaves differently depending on the underlying condition of the liver. Identifying the specific visual markers on diagnostic scans helps medical practitioners recognise how the disease manifests locally. Understanding that the disease strikes younger adults in this setting informs better diagnostic awareness and clinical assessment.
The abstract does not indicate a direct commercialisation or product application pathway, representing observational clinical research that informs radiology practices.
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ABSTRACT Background Hepatocellular Carcinoma (HCC) is the most common primary liver cancer typically occurring in the background of chronic liver disease and cirrhosis. Atypical occurrence of HCC is also present in non-cirrhotic livers. Objective The aim of this study was to determine the patterns of Hepatocellular carcinoma in patients with or without liver cirrhosis using Computed Tomography (CT) at Muhimbili National Hospital Methodology A retrospective cross-sectional study was done comparing the CT patterns of clinically suspected cases of HCC who underwent CT imaging at Muhimbili National Hospital from April 2021 to February 2022. Results A total of 73 cases were enrolled comprising of 78.1% (n = 57) HCC patients with Liver cirrhosis (HCC-LC) and 21.9% (n = 16) HCC patients without Liver cirrhosis (HCC-WLC). HCC-LC presented at a median age of 40 while HCC-WLC presented at a median age of 38. The male-to-female ratio of HCC-LC was 4:1 while that of HCC-WLC was 3:1. Abdominal pain located in the right upper quadrant was the major clinical symptom in both HCC-LC and HCC-WLC (n = 68, 93.2%). The most frequent identified risk factor in both HCC-LC and HCC-WLC was Hepatitis B (n = 40, 54.8%). On CT imaging, multifocal lesions were associated with HCC-LC while solitary lesions were associated with HCC-WLC (P = 0.01). Ill-defined lesions were associated with HCC-LC while well-defined lesions were associated with HCC-WLC (P < 0.01). Lesions in HCC-LC were also more likely to occur in Segment 2, 3 and 4 (P = 0.002, P = 0.003, P = 0.025 respectively). Conclusion Hepatocellular Carcinoma presents at an earlier age in Tanzania as compared to North America, Europe and Asia. On CT imaging, HCC in patients with liver cirrhosis appears as multifocal and ill-defined lesions favoring the left liver lobe while HCC in patients without liver cirrhosis appears as solitary and well-defined lesions.
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DOI: 10.1101/2025.05.15.25327588
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