Clinicopathological Discrepancies in the Diagnosis of Hepatocellular Carcinoma in Explanted Livers, A Single Center Study on More Than 1500 Transplanted Livers

Background Hepatocellular carcinoma is an unfortunate consequence in cirrhotic patients. Most of the cases are diagnosed by imaging modalities; however, some of them are missed and would be diagnosed only after thorough examination of the explanted liver following transplantation. Objectives In this study, we aimed to evaluate the frequency of incidental HCCs that are diagnosed after transplantation based on pathological examination of the explanted livers. Methods We evaluated all the explanted livers during 5 years from 2012 to 2016 with clinical and pathological diagnosis of HCC. In the meantime, all of the clinicopathological findings were investigated such as demographic information, AFP level, tumor size, and tumor location. Conclusions The frequency of incidental HCC in our center was around 20%, more than 80% of which were less than 2-cm in size (early HCC). Majority of the cases were male patients above 40 years age, with the underlying causes of Hepatitis B, C, and AIH as well as tyrosinemia and PFIC.