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Query: UMLS:C0019204 (
hepatocellular carcinoma
)
71,386
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Hepatocellular carcinoma
(
HCC
) accounts for more than 80% of all primary liver cancers and is one of the most common malignancies worldwide. Most patients with
HCC
also suffer from concomitant cirrhosis, which is the major clinical risk factor for hepatic cancer and results from
alcoholism
, infection with the hepatitis B or hepatitis C virus, and other causes.
HCC
is often diagnosed at an advanced stage, when established treatment options provide limited benefit. Effective treatment for
HCC
includes liver resection and liver transplantation. Under most clinical circumstances, those options provide a high rate of complete response and are thought to improve survival. Partial hepatectomy is the therapy of choice in patients with
HCC
and a noncirrhotic liver. Usually, liver transplantation is not indicated for such patients, although in individual cases, transplantation may be considered. For most cirrhotic patients who fulfill the Milan criteria, liver transplantation is the ultimate treatment option. Liver transplantation restores liver function and ensures the removal of all hepatic foci of tumor as well as tissue with a high oncogenic potential for early tumor recurrence. Because of the present lack of available organs, living-donor liver transplantation (LDLT) is an increasingly popular alternative. LDLT enables recipients to avoid a long pretransplantation waiting time and increases the number of livers available for transplantation. It is also the most effective approach to reducing the dropout rate. Strategies to reduce tumor growth in patients who are awaiting liver transplantation are important to ensure that those individuals continue to fulfill the Milan criteria for transplantation. For that purpose, using ablative techniques or chemoembolization to control local tumor growth is useful.
...
PMID:Liver resection and transplantation in the management of hepatocellular carcinoma: a review. 1723 57
A 65-year-old patient with a past medical history of hypertension,
alcoholism
, micronodular cirrhosis, and coronary artery bypass grafting 10 years ago developed a
hepatocellular carcinoma
, treated by chemoembolization. One month after treatment, thoracoabdominal CT scan showed no residual hepatic tumor, but tumoral aspect in the right atrium with extension into the inferior vena cava. The patient being asymptomatic, cardiac ultrasound confirmed the presence of a free, mobile, pediculated tumor in the right atrium. Surgical exploration found a well-circumscribed mass, attached to the atrial wall by a 1.5-cm diameter pedicle implanted near the inferior vena cava ostium, moving freely in the right atrial cavity. The tumor was easily resected by section of the pedicle and its surrounding parietal implantation zone. No complications occurred postoperatively, and the patient was discharged on the 10th postoperative day. Three years after, the patient is in good health and is asymptomatic; cardiac ultrasound showed no tumor recurrence.
...
PMID:Right atrial metastasis from hepatocellular carcinoma. 1748 26
Liver disease afflicts over 10% of the world population. This includes chronic hepatitis, alcoholic steatosis, fibrosis, cirrhosis and
hepatocellular carcinoma
(
HCC
), which are the most health-threatening conditions drawing considerable attention from medical professionals and scientists. Patients with
alcoholism
or viral hepatitis are much more likely to have liver cell damage and cirrhosis, and some may eventually develop
HCC
, which is unfortunately, and very often, a fatal malignancy without cure. While liver surgery is not suitable in many of the
HCC
cases, patients are mostly given palliative support cares or transarterial chemoembolization or systemic chemotherapies. However,
HCC
is well known to be a highly chemoresistant tumour, and the response rate is <10-20%. To this end, alternative medicines are being actively sought from other sources with hopes to halt the disease's progression or even eliminate the tumours. Traditional Chinese herbal medicine has begun to gain popularity worldwide for promoting healthcare as well as disease prevention, and been used as conventional or complementary medicines for both treatable and incurable diseases in Asia and the West. In this article, we discuss the laboratory findings and clinical trial studies of Chinese herbal medicines (particularly small molecule compounds) for the treatment of liver disease ranging from fibrosis to liver cancer.
...
PMID:Traditional Chinese herbal medicines for treatment of liver fibrosis and cancer: from laboratory discovery to clinical evaluation. 1769 25
Hepatocellular carcinoma
(
HCC
) continues to pose a worldwide burden on health resources with an occurrence of 1.4 million cases annually. It represents the fifth most common cancer in men and eighth most common in women worldwide. Eighty per cent of patients have a background cirrhotic liver, most commonly in the United States, resulting from chronic hepatitis C infection, whereas
alcoholism
also commonly contributes to the development of cirrhosis. Fifty per cent of patients diagnosed with
HCC
present with metastatic disease. Sites of metastasis commonly include the lungs, vertebral bones, and abdominal lymph nodes. Metastasis to the oral region is very rare. We report a 55-year-old man with metastatic
HCC
to the mandible. The patient was previously diagnosed with unresectable
HCC
and had undergone six cycles of chemoembolization therapy. Although the lesion remained stable in size, he did not qualify for liver transplantation because of active alcohol use. He presented to the emergency room for evaluation of recent-onset jaw pain. There was no history of trauma and an oral examination did not reveal any mucosal lesions. Mild swelling and tenderness of the right jaw was noted, and a subsequent CT scan revealed a right-sided mass centered around a fracture of the body of the mandible and surrounded by the masseter muscle. A biopsy of the mass revealed a metastatic
hepatocellular carcinoma
and a CT scan of the chest, abdomen, and pelvis confirmed it to be a solitary metastasis. The patient underwent surgical resection of a segment of the right mandible and the metastatic tumor. He continues to receive regional chemoembolization and is currently pain-free. Solitary metastasis to the mandible in the setting of
HCC
is exceedingly rare. Fine needle aspiration biopsy of the lesion with immunohistochemical analysis is useful in characterizing the lesion and identifying the primary site. Radiotherapy has been used to palliate mandibular metastases; however, surgical intervention proved to be very effective in managing this patient's disease.
...
PMID:Unresectable hepatocellular carcinoma with a solitary metastasis to the mandible. 1845 3
Hepatocellular carcinoma
(
HCC
) is the commonest primary malignant cancer of the liver in the world. Given that the burden of chronic liver disease is expected to rise owing to increasing rates of
alcoholism
, hepatitis B and C prevalence and obesity-related fatty liver disease, it is expected that the incidence of
HCC
will also increase in the foreseeable future. This article summarizes the international epidemiology, the risk factors and the pathogenesis of
HCC
, including the roles of viral hepatitis, toxins, such as alcohol and aflatoxin, and insulin resistance.
...
PMID:Hepatocellular carcinoma: epidemiology, risk factors and pathogenesis. 1866 17
The occurrence of de novo malignant neoplasias has been shown in postransplant patients under imunosuppression. It is the second leading cause of late death in liver transplant recipients. The greatest incidence is seen in cancers associated with chronic infection by human papilloma virus, skin cancers, oropharyngeal, and gastrointestinal (GI) malignancies. GI stromal tumors (GISTs) are the most common mesenchymal tumors of the GI tract. Rare cases are identified outside the GI tract are collectively known as extragastrointestinal stromal tumors (EGISTs). We present an EGIST case in a liver transplantation patient. A 64-year-old man underwent liver transplantation because of cirrhosis (hepatitis B virus and
alcoholism
) and
hepatocellular carcinoma
. Histopathologic findings revealed 2 trabecular hepatocellular carcinomas: a 3.5-cm-diameter lesion located at segment VIII and another 2-cm one at segment V. Seven months later, he noticed a hardened, mobile, painless, 3-cm subcutaneous nodule in the perineum localized in the right lateral quadrant 2 cm distant from the anus. A surgical resection with 1 cm margin yielded a histopathology report of a 5.0 x 3.0 cm spindle cell stromal tumor. The immunohistochemical profile was compatible with a GIST, with 5 mitosis per 50 high-powered fields. This tumor is extremely rare after liver transplantation but has shown a good outcome up to now.
...
PMID:Extragastrointestinal stromal tumor and liver transplantation: case report and review. 1910 Apr 89
Incidence and etiology of
hepatocellular carcinoma
(
HCC
) are variable around the world, depending mainly on theprevalence ofchronic hepatitis B carriers in each region. No study has been published analyzing epidemiological features of patients with
HCC
in Argentina. The aim of this retrospective study was to describe demographical and etiological results in a series of 587 consecutive patients with
HCC
diagnosed in 15 Hepatology and Gastroenterology Units distributed all around our country. Seventy-two per cent of patients were male, the median age was 62 years (interquartile range 55-68 years), and 93% had cirrhosis. Regarding to etiological data (fully available in 551 cases), main etiologies were
chronic alcoholism
in 229 patients (41.6%) (the sole risk factor in 182, associated to HCVin 35 and to HBV in 12); hepatitis C in 223 patients (40.5%) (the sole risk factor in 181, associated to
alcoholism
in 35 and to HBV in 7); hepatitis B in 74 patients (13.4%) (the sole risk factor in 55, associated to
alcoholism
in 12 and to HCV in 7); cryptogenic cirrhosis in 51 patients (9.2%). There were significant differences in percentages of genders between main groups: males were highly predominant in alcoholic cirrhosis (93%), hepatitis B (87%) and HCV plus alcohol (94%), compared to 63% in cryp togenic cirrhosis and 49% in hepatitis C (p<0.01). There were no differences in age at presentation between the main etiologies. In conclusion, the main causes of
HCC
in Argentina are alcoholic cirrhosis and hepatitis C (76% of cases). A majority of patients with
HCC
in our country are cirrhotics, males, and in their 6th or -7th decades of life.
...
PMID:Etiology of hepatocellular carcinoma in Argentina: results of a multicenter retrospective study. 1940 39
Chronic alcohol abuse
is an important cause of morbidity and mortality throughout the world. Liver damage due to
chronic alcohol intoxication
initially leads to accumulation of lipids within the liver and with ongoing exposure this condition of steatosis may first progress to an inflammatory stage which leads the way for fibrogenesis and finally cirrhosis of the liver. While the earlier stages of the disease are considered reversible, cirrhotic destruction of the liver architecture beyond certain limits causes irreversible damage of the organ and often represents the basis for cancer development. This review will summarize current knowledge about the molecular mechanisms underlying the different stages of alcoholic liver disease (ALD). Recent observations have led to the identification of new molecular mechanisms and mediators of ALD. For example, plasminogen activator inhibitor 1 was shown to play a central role for steatosis, the anti-inflammatory adipokine, adiponectin profoundly regulates liver macrophage function and excessive hepatic deposition of iron is caused by chronic ethanol intoxication and increases the risk of
hepatocellular carcinoma
development.
...
PMID:Current experimental perspectives on the clinical progression of alcoholic liver disease. 1964 34
Although chronic infection with hepatitis B virus and/or hepatitis C virus are the most important risk factors for
hepatocellular carcinoma
(
HCC
) worldwide, other causes of cirrhosis can also lead to
HCC
. Given the high prevalence of
alcoholism
and the worldwide obesity epidemic, the relevant importance of nonviral liver disease-related
HCC
is expected to increase in the future. Some evidence supports mechanistic interactions between host or environmental factors and chronic viral hepatitis in the development of
HCC
. For example, food- and water-borne carcinogens have contributed to unusually high rates of
HCC
in parts of China and sub-Saharan Africa. With some of these conditions, appropriate public health measures to reduce the population's exposure to known etiologic agents, or early therapeutic intervention for 'at-risk' individuals before development of cirrhosis (e.g. hereditary hemochromatosis) can prevent
HCC
. Community-based programs to discourage and deal with excessive alcohol intake, to promote tobacco smoking awareness, to avoid exposure to aflatoxin and other food toxins, and measures to reduce the pandemic of obesity and diabetes are vital for effective interruption of the rising tide of
HCC
from nonviral liver disease.
...
PMID:Prevention of hepatocellular carcinoma in nonviral-related liver diseases. 1964 14
Uip to 20% of patients with liver cirrhosis develop hepatogenous diabetesdue to the hepatocellular functional loss and insulin resistance. Optimizing diabetic metabolic conditions is not only important to avoid typical late complications of diabetes, but also cirrhosis-associated complications e.g. gastrointestinal bleeding, hepatic encephalopathy or the occurence of
hepatocellular carcinoma
. So far there have beenno recommendations orguidelines for the diagnosis and treatmentof hepatogenous diabetes. The medical teatment of a diabetic condition is mainly influenced by its side effects. The risk of hypoglycemia must be considered carefully during drug treatment, especially in patients with
chronic alcohol abuse
. Suitable oral antidiabetics are glinides and short-acting sulfonylureas or possibly meal-related insulin administration with short-acting insulins or rapid-acting insulin analogues. Biguanide and PPAR-gamma agonists are contraindicated because of side effects in liver cirrhosis. Regarding basic treatment, an adequate daily energy and protein supply should be ensuredbecause the majority of patients with liver cirrhosis are malnourished.
...
PMID:[Metabolic disturbances in liver cirrhosis (part 2), hepatogenous diabetes: diagnostic aspects and treatment]. 2035 3
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