Hepatocarcinoma diagnosis. Reflection is required.

Abstract

The editorial published in this same journal entitled "Sombras del tratamiento actual del hepatocarcinoma en España: una verdad incómoda" has awakened the need to review the available scientific literature on the precise diagnosis of hepatocarcinoma based on a clinical case. A 58-year-old male patient has a radiological finding in the left hepatic lobe of a new lesion of 3.5 cm in size. Nuclear magnetic resonance imaging and computerized axial tomography confirmed the typical radiological behavior of hepatocarcinoma. However, the definitive pathological anatomy (A-P) after surgery was compatible with intrahepatic cholangiocarcinoma. The main national and international clinical guides offer the use of imaging tests for diagnosis, especially in high-risk patients. However, diagnostic biopsy is not included as mandatory in the hepatocarcinoma diagnostic process, although it may be recommended in some cases. The interest of the clinical case we present establishes the relevance of reaching a histological diagnosis of certainty, since imaging tests can objectify findings that are confusing with other tumor histologies, with future therapeutic and prognostic implications.