Gastroenterology Book


Hepatocellular Carcinoma

Aka: Hepatocellular Carcinoma, Hepatoma
  1. Epidemiology
    1. Most common internal cancer worldwide
    2. Highest Incidence where Hepatitis B is endemic
      1. Southeast Asia
      2. Sub-Saharan Africa
    3. Less common in the United States
    4. Incidence in men 2-4 times more common than women
    5. Incidence peaks in ages 50-70 years old
  2. Risk Factors
    1. Chronic Active Hepatitis B
      1. Highest risk if congenitally acquired
    2. Hepatitis C Infection
    3. Cirrhosis
    4. Hemochromatosis
    5. Alpha-1-Antitrypsin Deficiency
    6. Tyrosinosis
    7. Anabolic Steroid use
    8. Fungal metabolite ingestion (aflatoxin)
  3. Symptoms
    1. Weight loss
    2. Right Upper Quadrant Abdominal Pain
  4. Signs
    1. Tender, hard, palpable liver mass
    2. Ascites (25%)
    3. Peritoneal friction rub
    4. Hepatic bruit
  5. Labs
    1. Liver Function Tests
      1. Alkaline Phosphatase elevated
      2. 5'-nucleotidase elevated
    2. Tumor Marker: Serum Alpha-fetoprotein >20 ng/ml
      1. Test Sensitivity: 64%
      2. Test Specificity: 91%
  6. Radiology
    1. Liver Ultrasound
      1. Test Sensitivity: 59% to 74%
      2. Test Specificity: 94%
    2. Triphasic Liver CT (arterial contrast images)
      1. Detects tumors <2 cm in diameter
  7. Diagnosis: Liver biopsy
    1. Percutaneous
    2. Surgical (Laparoscopy or Laparotomy)
  8. Management
    1. Curative Measures
      1. Curative resection in only 5%
      2. Liver Transplantation for small tumors without spread
    2. Palliation
      1. Radiation Therapy
      2. Selective arterial embolization
      3. Chemotherapy not beneficial
      4. Radiofrequency Ablation (nonresectable tumor)
        1. Small trials suggest prolonged survival or cure
        2. Wong (2001) Am J Surg 182:552-7 [PubMed]
  9. Prevention
    1. Hepatitis BVaccination for global Immunity
  10. References
    1. Akriviadis (1998) Br J Surg 85(10):1319-31 [PubMed]
    2. Ulmer (2000) Postgrad Med 107(5):117-24 [PubMed]

Liver carcinoma (C2239176)

Definition (MSHCZE) Zhoubný nádor jater, maligní hepatom. Vzniká větš. na základě cirhózy, z podílu na vzniku se obviňují rovněž viry hepatitidy B a C a některé toxické vlivy. Je častější v rozvojových zemích. Má charakter opouzdřený nebo infiltrující. Klinicky se projeví zejm. obrazem dekompenzované jaterní cirhózy. V diagnostice se uplatňují zobrazovací metody, biopsie, laboratorně bývá zvýšen alfa-fetoprotein. V léčbě se provádí resekce (je-li možná), cytostatika se obv. podávají místně. Prognóza je obv. špatná. (cit. Velký lékařský slovník online, 2013 )
Definition (NCI_NCI-GLOSS) A type of adenocarcinoma and the most common type of liver tumor.
Definition (NCI) A malignant tumor that arises from hepatocytes. Hepatocellular carcinoma is relatively rare in the United States but very common in all African countries south of the Sahara and in Southeast Asia. Most cases are seen in patients over the age of 50 years, but this tumor can also occur in younger individuals and even in children. Hepatocellular carcinoma is more common in males than females and is associated with hepatitis B, hepatitis C, chronic alcohol abuse and cirrhosis. Serum elevation of alpha-fetoprotein occurs in a large percentage of patients with hepatocellular carcinoma. Grossly, hepatocellular carcinoma may present as a single mass, as multiple nodules, or as diffuse liver involvement. Microscopically, there is a wide range of differentiation from tumor to tumor (well differentiated to poorly differentiated tumors). Hepatocellular carcinomas quickly metastasize to regional lymph nodes and lung. The overall median survival of untreated liver cell carcinoma is about 4 months. The most effective treatment of hepatocellular carcinoma is complete resection of the tumor. Lately, an increasing number of tumors have been treated with liver transplantation.
Definition (NCI_CDISC) A malignant neoplasm arising from hepatocytes.
Definition (MSH) A primary malignant neoplasm of epithelial liver cells. It ranges from a well-differentiated tumor with EPITHELIAL CELLS indistinguishable from normal HEPATOCYTES to a poorly differentiated neoplasm. The cells may be uniform or markedly pleomorphic, or form GIANT CELLS. Several classification schemes have been suggested.
Definition (CSP) primary malignant neoplasm of epithelial liver cells; it ranges from a well-differentiated tumor with epithelial cells indistinguishable from normal hepatocytes to a poorly differentiated neoplasm; the cells may be uniform or markedly pleomorphic, or form giant cells; associations exist with chronic hepatitis B virus infection, some types of cirrhosis, and hepatitis C virus infection.
Concepts Neoplastic Process (T191)
MSH D006528
ICD10 C22.0, M8170/3
SnomedCT 154469006, 269547001, 109841003, 25370001, 187769009
English Carcinoma, Hepatocellular, Carcinomas, Hepatocellular, Hepatocellular Carcinoma, Hepatocellular Carcinomas, Hepatoma, Hepatomas, HEPATOCELLULAR CARCINOMA, LCC, LIVER CELL CARCINOMA, HCC, HEPATOMA, Hepatocellular ca. NOS, [M]Hepatocellular ca. NOS, Hepatocellular carcinoma NOS, [M]Hepatocellular carcinoma NOS, carcinoma of liver (diagnosis), hepatocellular carcinoma of liver (diagnosis), hepatocellular carcinoma of liver, liver neoplasm malignant carcinoma, carcinoma of liver, Liver carcinoma, Liver Cell Cancer (Hepatocellular Carcinoma), Carcinoma, Hepatocellular [Disease/Finding], Cancers, Adult Liver, Liver Cell Carcinoma, Adult, Adult Liver Cancer, Liver Cancer, Adult, Cancer, Adult Liver, Adult Liver Cancers, Liver Cancers, Adult, hepatomas, hepatic carcinoma, liver cell carcinoma, liver cell cancer, liver carcinoma, Liver Cell Carcinomas, Cell Carcinoma, Liver, Cell Carcinomas, Liver, Liver Cell Carcinoma, Carcinoma, Liver Cell, Carcinomas, Liver Cell, Carcinoma hepatocellular, Carcinoma liver, Carcinoma of liver, Hepatic cell carcinoma, liver neoplasm malignant carcinoma primary, Primary carcinoma of liver (diagnosis), hepatoma, CARCINOMA, HEPATOCELLULAR, MALIGNANT, CARCINOMA OF THE LIVER CELLS, PRIMARY CARCINOMA OF THE LIVER CELLS, hepatocellular carcinoma, CARCINOMA OF LIVER CELLS, PRIMARY CARCINOMA OF LIVER CELLS, Liver cell carcinoma, Hepatocarcinoma, Hepatoma, malignant, Hepatocellular carcinoma, Malignant hepatoma, LCC - Liver cell carcinoma, HCC - Hepatocellular carcinoma, Primary carcinoma of liver, Hepatocellular carcinoma (clinical), Hepatocellular carcinoma (morphologic abnormality), Liver cell carcinoma (clinical), Liver cell carcinoma (disorder), Primary carcinoma of liver (disorder), hepatocarcinoma, carcinoma; hepatic cell, carcinoma; hepatocellular, hepatic cell; carcinoma, hepatocellular; carcinoma, Hepatocellular carcinoma, NOS, Hepatoma, NOS, Primary Carcinoma of Liver Cells, Primary Carcinoma of the Liver Cells, Carcinoma of Liver Cells, Carcinoma of the Liver Cells, Carcinoma of liver, specified as primary, Carcinoma of liver cell
French HEPATOME, CHC (Carcinome HépatoCellulaire), Carcinome du foie, Carcinome hépatique, Hépatome, Cancer hépatique de l'adulte, Hépatocarcinome de l'adulte, Cancer du foie de l'adulte, Carcinome hépatocellulaire de l'adulte, Carcinome hépato-cellulaire, Carcinome hépatocellulaire, Hépatocarcinome, Hépatome malin
Portuguese HEPATOMA, Carcinoma do fígado, Carcinomahepatocelular, Carcinoma hepatocelular, Carcinoma Hepatocelular, Hepatoma
Spanish HEPATOMA, Carcinoma hepático, Carcinoma de hígado, Carcinoma hepatocelular, (M)carcinoma hepatocelular, carcinoma de células hepáticas (clínico), carcinoma de células hepáticas (trastorno), carcinoma de células hepáticas, carcinoma hepatocelular (clínico), carcinoma hepatocelular, carcinoma hepatocítico (anomalía morfológica), carcinoma hepatocítico, carcinoma primario del hígado (trastorno), carcinoma primario del hígado, hepatocarcinoma, hepatoma, maligno, hepatoma, Hepatoma, Carcinoma Hepatocelular
Swedish Karcinom, hepatocellulärt
Finnish Pahanlaatuinen maksasolukasvain
Italian Epatoma, Carcinoma del fegato, Carcinoma epatocellulare
German HEPATOM, Leberzellkarzinom, Karzinom der Leber, Hepatozellulaeres Karzinom, Karzinom, hepatozellulaer, Leberkarzinom, Hepatom, Hepatozelluläres Karzinom, Karzinom, hepatozelluläres
Korean 간세포 암종
Polish Wątrobiak, Rak wątrobowokomórkowy
Japanese 肝細胞癌, 肝癌(肝細胞癌), カンサイボウガン, 肝癌, カンガン, ヘパトーム, 原発性肝細胞がん, 原発性肝細胞癌, 肝細胞がん, 肝細胞がん-原発性, 肝細胞癌-原発性
Czech hepatocelulární karcinom, karcinom hepatocelulární, hepatom, karcinom z jaterních buněk, rakovina jater dospělých, Hepatocelulární karcinom, Karcinom jater, Hepatom, Karcinom hepatocelulární, HCC
Norwegian Levercellekarsinom, Primær leverkreft, Hepatocellulært karsinom, Leverkreft hos voksne, Hepatom
Dutch carcinoom lever, levercarcinoom, carcinoom van de lever, hepatoom, hepatocellulair carcinoom, carcinoom hepatocellulair, carcinoom; hepatocellulair, carcinoom; levercel, hepatocellulair; carcinoom, levercel; carcinoom, Carcinoom, hepatocellulair, Hepatocellulair carcinoom, Hepatoom, Levercelcarcinoom
Hungarian Májcarcinoma, Hepatoma, Hepatocellularis carcinoma, Májrák
Derived from the NIH UMLS (Unified Medical Language System)

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