Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

FNH of the liver is extremely rare during childhood. Based on relevant literature and two of our own cases the diagnosic problems are presented. Unless a clear diagnosis can be obtained by using US (Ultrasonic), CT, Szintegraphy and Angiography, laparotomy should be carried out to avoid confusion with hepatocellular carcinoma or hepatocellular adenome which can become malignant. With the exception of biopsy the higher degree of diagnostic accuracy is obtained with celiacography. Since FNH does not have a tendency towards malignancy, total extsirpation should not be attempted if vital structures are endangered.
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PMID:[Focal nodular hyperplasia of the liver in childhood]. 228 13

There are now many types of liver resection, depending on the amount of liver to be resected and the surgical technique selected. In the field of anatomical surgery the surgeon can choose between a major or a lesser hepatectomy and between preliminary ligation of the vessels or a primary parenchymatous resection. Sound knowledge of the anatomy is a prerequisite for anatomical surgery of this organ. Although confusion has existed as a result of differences in the nomenclature of the functional anatomy of the liver, we believe that the numerical segmental description of Couinaud is the most accurate and most easily understood. Operative ultrasonography has a fundamental role in liver surgery. It supplements information obtained by intensive preoperative investigations and enables the surgeon to make more precise and limited resections than were previously possible. It provides a greater range of options in the management of hepatocellular carcinoma. The surgeon confronted with a malignant tumour of the liver should base his decision for resection on the tumour characteristics: primary or secondary, extra- or intrahepatic spread, position, histological differentiation and presence or absence of cirrhosis. Anatomical resections should be performed providing good tumour clearance margins, while preserving as much functional parenchyma as possible. Supplementary therapies such as arterial ischaemia and chemotherapy should always be considered, but it must be borne in mind that at present hepatic resection offers the only hope of cure for malignant hepatic tumours.
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PMID:Surgical management of space-occupying lesions in the liver. 254 39

An 18 year old woman had been known to have juvenile polyposis since five years with multiple hyperplastic polyps of the stomach and several polyps of the colon. Death occurred from hepatic coma with hepatocellular carcinoma. A lymphangiosis carcinomatosa was observed in some stomach polyps with a circumscribed infiltration into the stroma and into the adjacent glands. Such an unusual combination of diseases readily causes diagnostic confusion.
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PMID:[Concurrent appearance of stomach polyposis and hepatocellular carcinoma]. 303 26

A case of visceral botryomycosis of the liver in a 50-year-old man is reported. The clinical diagnosis was hepatocellular carcinoma. Pathological examination of the surgically resected specimen demonstrated microabscesses containing gram- positive microorganisms with surrounding fibrosis replacing liver parenchyma. An immune deficiency state was not demonstrated. Recognition of this condition is important because of its clinical confusion with malignancy and its histological similarity to actinomycosis, nocardia, and eumycotic infections.
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PMID:Botryomycosis of the liver. 755 10

Ovarian germ cell tumors are reviewed with emphasis on recent developments. In the primitive germ cell tumor group the recently recognized subtypes of yolk sac tumor, the hepatoid and glandular variants are described. Hepatoid tumors, which resemble hepatocellular carcinomas, are usually admixed with other patterns of yolk sac neoplasia but when the hepatoid component predominates, distinction from metastatic hepatocellular carcinoma may be difficult. Glandular yolk sac tumors include those with a cribriform pattern as well as tumors that may be confused with endometrioid carcinoma. Within the teratoma category, a recent paper exploring the occasional relation between immature teratomas and dermoid cysts is reviewed. Problems caused by some of the monodermal teratomas are also highlighted. Struma ovarii may be the source of many diagnostic problems. It may be cystic and microscopic examination may reveal inconspicuous numbers of clearly recognizable thyroid follicles, resulting in confusion with other cystic ovarian tumors. In noncystic strumas many patterns, such as solid or pseudotubular, may be seen and the presence of cells with abundant clear or eosinophilic cytoplasm may add to the diagnostic difficulty, particularly if other teratomatous elements are lacking. Immunohistochemical staining for thyroglobulin may be crucial in establishing the diagnosis of a struma in these situations. The problem of identifying reliable criteria for malignancy of struma ovarii is explored on the basis of recent information. The two most recently recognized subtypes of carcinoid tumor, strumal and mucinous, are reviewed as are primary neuroectodermal and sebaceous tumors of the ovary. Unusual clinical features of germ cell tumors are discussed under three main categories: endocrine syndromes, paraendocrine and paraneoplastic syndromes, and miscellaneous. Included in these categories are disorders such as sexual precocity in association with germ cell tumors containing syncytiotrophoblast cells, endocrine abnormalities associated with the recently described functioning ovarian tumors with peripheral steroid cell proliferation, hyperthyroidism with struma ovarii, the carcinoid syndrome, autoimmune hemolytic anemia associated with dermoid cysts, complications of dermoid cyst rupture, which may simulate disseminated carcinomatosis, and ascites and Meigs' syndrome associated with struma ovarii.
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PMID:New and unusual aspects of ovarian germ cell tumors. 769 12

In an earlier phase I study, we reported that the maximal tolerated dose (MTD) of prochlorperazine (PCZ) given as a 15-min i.v. infusion was 75 mg/m2. The highest peak plasma PCZ concentration achieved was 1100 ng/ml. The present study was conducted to determine if PCZ levels high enough to block doxorubicin (DOX) efflux in vitro could be achieved and sustained in vivo by increasing the duration of i.v. infusion from 15 min to 2 h. The treatment schedule consisted of i.v. prehydration with at least 500 ml normal saline (NS) and administration of a fixed standard dose of 60 mg/m2 DOX as an i.v. bolus over 15 min followed by i.v. doses of 75, 105, 135, or 180 mg/m2 PCZ in 250 ml NS over 2 h. The hematologic toxicities attributable to DOX were as expected and independent of the PCZ dose. Toxicities attributable to PCZ were sedation, dryness of mouth, anxiety, akathisia, hypotension, cramps, and confusion. The MTD of PCZ was 180 mg/m2. Large interpatient variation in peak PCZ plasma levels (91-3215 ng/ml) was seen, with the plasma half-life (t1/2 alpha) being approximately 57 min in patients given 135-180 mg/m2 PCZ. The volume of distribution (Vd), total clearance (ClT), and area under the curve (AUC) were 350.1 +/- 183.8 1/m2, 260.7 +/- 142.7 l m2 h-1 and 1539 +/- 922 ng ml h-1, respectively, in patients given 180 mg/m2 PCZ and the respective values for patients receiving 135 mg/m2 were 48.9 +/- 23.76 l/m2, 33.2 +/- 2.62 l m2 h-1, and 4117 +/- 302 ng ml h-1. High PCZ plasma levels (> 600 ng/ml) were sustained in all patients treated with 135 mg/m2 PCZ for up to 24 h. DOX plasma elimination was biphasic at 135 and 180 mg/m2 PCZ, and a > 10-ng/ml DOX plasma level was maintained for 24 h. Partial responses were seen in three of six patients with malignant mesothelioma, in two of ten patients with non-small-cell lung carcinoma, and in the single patient with hepatoma. Our data show that PCZ can be safely given as a 2-h infusion at 135 mg/m2 with clinically manageable toxicities. The antitumor activity of the combination of DOX and PCZ needs to be confirmed in phase II trials.
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PMID:Phase I and pharmacokinetics studies of prochlorperazine 2-h i.v. infusion as a doxorubicin-efflux blocker. 807 4

We report the MR findings of a case of fibrolamellar hepatocellular carcinoma that fulfilled MR criteria proposed as diagnostic of focal nodular hyperplasia. Because confusion of fibrolamellar carcinoma with focal nodular hyperplasia could result in a missed opportunity for cure, pathologic assessment remains necessary in cases demonstrating these MR findings that do not show radiotracer uptake on 99mTc-sulfur colloid scintigraphy.
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PMID:Fibrolamellar hepatocellular carcinoma: MR appearance mimicking focal nodular hyperplasia. 812 88

A large number of ascitic fluid tests, e.g., fibronectin and cholesterol, have been proposed as helpful in detecting malignancy as the cause of ascites. Unfortunately, these "humoral tests of malignancy" are nonspecific. Although the ascitic fluid concentrations of these proteins or protein-bound substances tend to be quite high in patients with peritoneal carcinomatosis and low in the setting of cirrhotic ascites, the problem is that patients with tuberculous peritonitis, cardiac ascites, pancreatitis ascites, etc. usually have values in the malignancy range, i.e., false-positive results. This can lead to an extensive search for a nonexistent tumor, with confusion and anxiety for patient and physician. The cytology is the single best test to order when peritoneal carcinomatosis is suspected; its sensitivity approaches 100%. However, peritoneal carcinomatosis is only one of several mechanisms by which tumors can cause ascites. No one test can be expected to detect tumors as the cause of these diverse mechanisms of ascites formation. The serum-ascites albumin gradient is a helpful test in classifying ascitic fluid specimens into portal-hypertension-related and non-portal-hypertension-related categories. An elevated serum alpha-fetoprotein test can be useful in raising suspicion of hepatocellular carcinoma. Careful analysis of ascitic fluid, without measurement of "humoral tests of malignancy," combined with information obtained from the history and physical examination, usually lead to an accurate diagnosis of the cause of ascites.
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PMID:Malignancy-related ascites and ascitic fluid "humoral tests of malignancy". 818 30

A retrospective review of 54 cases of adrenal gland needle biopsy in 53 patients is presented. The cases included 43 fine-needle aspirations (FNA), six core-needle biopsies, and five cases in which both types of needle biopsy were done. Clinical or histologic follow-up was available in 28 of the 36 specimens deemed adequate for evaluation. Metastatic malignancies represented the largest group of cases (19), with lung being the most common primary site (8). The series included four cases of metastatic hepatocellular carcinoma. Probable adrenocortical adenoma was the next most common diagnosis (12 cases). Cases causing diagnostic confusion included a case of metastatic well-differentiated hepatocellular carcinoma which was initially confused with an adrenocortical adenoma and a probable adrenocortical adenoma which was mistaken for a metastatic small round cell malignancy. (This case is unproved because of lack of clinical or histologic follow-up). By evaluating only those cases with histologic confirmation or clinical follow-up greater than one year, the sensitivity of needle biopsy for the presence of malignancy was 95% and the specificity was 100%. The cytologic findings are described with attention to the potential problem of confusing primary adrenocortical neoplasms with metastases from hepatocellular carcinoma.
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PMID:Needle biopsy of the adrenal gland: retrospective review of 54 cases. 896 68

We describe a case of primary nonfunctioning paraganglioma that, unlike any other previously reported case, was strictly confined to the liver and must therefore have arisen on liver parenchyma. An asymptomatic 46-year-old man was referred to us for laparotomy and a right hemihepatectomy after a preoperative diagnosis of fibrolamellar hepatocellular carcinoma, based on a fine-needle biopsy. An 8-cm resiliently firm, pale gray nodule with a large central area of fibrosis and a thin fibrous capsule was resected. The polygonal eosinophilic tumor cells containing round nuclei lacking nucleoli were arranged in small nests set in a vascularly rich stroma. At immunohistochemistry neoplastic cells were strongly positive for chromogranin A, neuron-specific enolase, synaptophysin, and IGF-II protein; they were negative for keratin, S-100 protein, CD10, vimentin, and smooth muscle actin. In situ hybridization confirmed that, as in other sites, liver paraganglioma can express IGF-II gene. Conversely (and unlike hepatocellular carcinomas), the neoplastic cells did not express albumin mRNA, which was detected only in surrounding hepatocytes. The clinical course was benign and the patient is well and free of neoplastic disease 9 years after surgery. Knowledge of the entity should avoid possible confusion with hepatocellular carcinoma, especially of the fibrolamellar variety.
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PMID:Primary paraganglioma strictly confined to the liver and mimicking hepatocellular carcinoma: an immunohistochemical and in situ hybridization study. 1213 Nov 64


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