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• Hepatocellular Carcinoma (HCC), if within Milan Criteria, is an indication for liver transplantation.
• In contrast, intrahepatic cholangiocarcinoma (IHCC) is a contra-indication to liver transplantation due to high rates of recurrence.
• LI-RADS 5 classification (synonymous with OPTN-5) carries a near 100% positive predictive value for HCC, allowing prioritization of patients for liver transplantation without histological confirmation.
• The “LI-RADS M” classification indicates the presence of malignancy not meeting diagnostic criteria for HCC. In theory, IHCC lesions should be identified as LI-RADS M and not LI-RADS 5.
Gastroenterology | Hepatology | Oncology | Pathology | Radiology
Dhanekula, MD, Raja K.; Mitchell, MD, Donald; Farber, MD, John; Sama, MD, Ashwin R.; and Civan, MD, Jesse M., "Intrahepatic Cholangiocarcinoma Presenting as LI-RADS 5 "HCC"" (2016). Department of Gastroenterology and Hepatology Posters.