Objectives

The purpose of the exhibit is to recognize various cases of multistep carcinogenesis in the abdominal tumors, and to suggest a clinical significance such as early disease detection and disease-prevention.

Background

Carcinogenesis is a multistep process in which cells accumulate multiple genetic alterations. In abdominal tumors, several different kinds of genetic alteration such as APC and KRAS mutation have been reported. Chronic infections and inflammatory diseases may contribute to the multistep carcinogenesis.

Recognizing of the radiological findings of the multistep carcinogenesis leads us not only to early detect precancerous lesion, but also to prevent the carcinogenesis.

Imaging findings OR Procedure findings

Case presentations: we reviewed the cases of multistep carcinogenesis in the abdominal tumors:

a) Gastrointestinal tract: chronic atrophic gastritis progressing to gastric cancer, familial adenomatous polyposis and colorectal cancer.

b) Liver: hepatocellular carcinoma caused by chronic viral hepatitis, cirrhosiss, and nonalcoholic fatty liver disease, cholangiocarcinoma arising from bile duct adenoma.

c) Pancreas: intraductal papillary mucinous carcinoma

d) Gall bladder: gall bladder cancer associated with pancreaticobiliary maljunction.

In each case, we described the multimodality imaging features such as CT, MRI, US, and barium fluoroscopy.

Discussion

The clinical significance such as differential diagnosis, early disease detection and disease-prevention are mentioned.

Conclusion

Understanding the radiological findings of the multistep carcinogenesis in abdominal tumors is vital for radiologists not only to make a correct diagnosis, but also to contribute the patient prognosis.