Overview
Satellite lesions are small secondary tumor nodules located within 2 cm of a dominant (primary) HCC tumor. They arise from intrahepatic spread of cancer cells and typically cluster in the same segment or lobe as the main lesion.
Definition
Satellite lesions are small secondary tumor nodules located within 2 cm of a dominant (primary) HCC tumor. They arise from intrahepatic spread of cancer cells and typically cluster in the same segment or lobe as the main lesion.
Ultrasound Features
| Feature | Description |
|---|---|
| Size | Small (<2 cm), often hypoechoic |
| Number | Few to many, depending on disease extent |
| Distribution | Surrounding dominant mass, typically segmental or bi-lobar |
| Echotexture | Similar to primary tumor—heterogeneous or hypoechoic |
| Margins | May be well-defined or ill-defined |
| CEUS/Doppler | Show same vascular behavior: arterial phase hyperenhancement → portal/late washout |
Pathophysiology
- Arise from microscopic invasion of surrounding liver tissue
- Reflect local metastasis of HCC cells
- Frequently found in moderate-to-poorly differentiated tumors
Clinical Importance
| Aspect | Impact |
|---|---|
| Diagnosis | Confirm multifocal HCC (vs single mass) |
| Staging | Upgrades from early to intermediate/advanced stage |
| Treatment | Contraindicates surgery/transplant if extensive |
| Prognosis | Indicates higher risk of recurrence and worse survival |
Imaging Note:
Satellite lesions are often missed on B-mode ultrasound alone, especially in cirrhotic livers. Use of contrast-enhanced ultrasound (CEUS), CT, or MRI improves detection.
Satellite lesions are often missed on B-mode ultrasound alone, especially in cirrhotic livers. Use of contrast-enhanced ultrasound (CEUS), CT, or MRI improves detection.
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