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)

Hepatocellular carcinoma commonly invades the portal vein but is rarely seen in the bile duct. When seen, a minor intraductal component usually accompanies a prominent hepatic involvement. We report a case of hepatocellular carcinoma that entirely involved the common bile duct, the hepatic involvement was undiscernible at operation or ultrasonography. The patient had obstructive jaundice both at first presentation and at recurrence. The liver was normal at both explorations. The elevated AFP levels returned to normal after second resection. The diagnosis was confirmed by electron microscopy.
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PMID:Intraductal hepatocellular carcinoma with normal liver--case report. 172 65

A perspective on serum alkaline phosphatase isoenzymes in liver disease is provided with a brief discussion of the location of the enzyme in liver and its presumed function. Mechanisms of entry of alkaline phosphatase into serum in liver disease are discussed. Characterization of high molecular weight alkaline phosphatase in obstructive jaundice is reviewed. The relationship between blood group O and the appearance of the intestinal enzyme in sera of such subjects with cirrhosis of liver is discussed. Properties of hepatoma alkaline phosphatase and the genesis of liver alkaline phosphatase in diseases not related to the liver are explored. Methods for detection of serum alkaline phosphatase isoenzymes in liver disease are discussed from the standpoint of the limitations of electrophoretic procedures, and the promise of procedures such as isoelectric focusing and high performance liquid chromatography that are currently non-routine.
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PMID:Serum alkaline phosphatase isoenzymes as markers of liver disease. 201 75

Tissue plasminogen activator (t-PA) in plasma obtained from patients with acute hepatitis, chronic hepatitis, liver cirrhosis, hepatocellular carcinoma, drug-induced intrahepatic cholestasis, obstructive jaundice, fulminant hepatitis or disseminated intravascular coagulation (DIC), was analysed chromatographically. Liver disease cases showed a new peak (peak C) on HPLC fractionation. The protein of peak C had a lower molecular weight than ovalbumin. Lysine- and zinc- chelating affinity chromatography revealed that the peak C consist with the light chain (L-chain) of t-PA. The L-chain was also found in patients with DIC, but disappeared after improvement of DIC. Therefore, it was suggested that appearance of the L-chain would be related to acceleration of secondary fibrinolysis in plasma. The L-chain was especially high in plasma obtained from patients with decompensated liver cirrhosis. These results indicated that high increase of the L-chain in cases of severe liver disease may be due to either impaired clearance of t-PA in the liver or secondary hyperfibrinolysis accompanied by DIC. We concluded that determination of the L-chain of t-PA may contribute to clarify the mechanism of hyperfibrinolysis in liver diseases.
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PMID:[Qualitative analysis of tissue plasminogen activator in plasma obtained from various liver diseases by gel filtration and affinity chromatography]. 210 95

An autopsy case of a hepatocellular carcinoma with an omental mass, a laryngeal metastasis, and a coexisting pancreatic head carcinoma is reported and the diagnostic problems it presented is discussed. An obstructive jaundice was treated by transhepatic drainage, and was proved to be caused by the invasion into the bile duct of the hepatocellular carcinoma and not the pancreatic head tumor. An asymptomatic, papillomatous growth from the metastasis of the hepatocellular carcinoma was found in subglottic region, an extremely rare type of metastasis .
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PMID:[A case of icteric hepatoma with laryngeal metastasis and coexisting pancreatic cancer]. 215 80

Between July 1973 and September 1988, 119 patients with hepatocellular carcinoma underwent hepatic resection at Keio University Hospital, Tokyo. Hepatic resection was performed not only for patients with liver cirrhosis and obstructive jaundice but also for patients with advanced disease. Eighty (67.2%) of the 119 patients had liver cirrhosis and four patients had obstructive jaundice. Two or more segments of the liver were resected in 56 (47.0%) patients, 29 of whom had liver cirrhosis. Eleven patients died within 30 days after surgery, an operative mortality rate of 9.2%. Seven additional patients could not be discharged from the hospital, resulting in a hospital death rate of 5.9%. Seventeen of these 18 patients had cirrhosis. Selection of patients with sufficient reserve function of the remaining liver portion, caused a great reduction of the incidence of postoperative death. The 5-year actuarial survival rate for the 101 patients who were discharged from the hospital was 39%, and 13 patients lived longer than 5 years, the longest survival period being 13 years 10 months. Hepatocellular carcinoma is amenable to hepatic resection if patients with sufficient reserve function of the liver are selected.
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PMID:Hepatic resection for hepatocellular carcinoma. 215 90

Percutaneous ethanol injection therapy, a kind of non-vascular intervention, has recently been high-lighted as an effective therapy for small liver cancer. According to our experience, results of this therapy were excellent in cases where the amount of ethanol injected could be elevated over 1.5 times the estimated tumor volume. This result indicates that treatment with ethanol injection alone should be confined to small hepatocellular carcinoma with diameter below 3 cm. In patients with hepatocellular carcinoma who do not sufficiently respond to transcatheter chemoembolization, the combined use of ethanol injection therapy can improve therapeutic results. That is, ethanol injection therapy is indicated in cases where tumor has collateral blood supply other than hepatic artery, cases where hepatic artery has been obstructed, and cases where Lipiodol used for trans-catheter chemoembolization cannot be retained in tumor tissue. Furthermore, cases of giant hepatocellular carcinoma or tumor accompanied by obstructive jaundice have sometimes been treated with a combination of incomplete chemoembolization and ethanol injection therapy. Even in patients showing intraportal tumor thrombus, ethanol injection effectively relieved the thrombus.
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PMID:[Percutaneous ethanol injection therapy for hepatocellular carcinoma]. 216 75

Transcatheter chemo-embolization is an effective treatment for hepatocellular carcinoma, but some patients do not respond sufficiently. We have also percutaneous ethanol injection in patients who failed to respond to chemo-embolization alone, to improve the results of the treatment. Ten patients received the combined therapy; two had failed to retain Lipiodol in the lesions long enough after oily chemo-embolization, 3 had extrahepatic collateral blood supply, 2 had giant hepatocellular carcinomas 10 cm or more in diameter, which were supplied with blood from both the right and left hepatic arteries, 2 also had obstructive jaundice, and one had intraportal tumor thrombus as well. Ethanol was mixed with Lipiodol at 1/10 to 1/5 the volume of ethanol, and injected under ultrasonic or fluoroscopic control. Five to 10 ml of the mixture was injected until the tumors were filled with Lipiodol. It is difficult to discuss the effectiveness of the combined therapy, but it seemed to provide a safer and more effective treatment.
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PMID:[Combined therapy with transcatheter chemo-embolization and percutaneous ethanol injection]. 216 46

Eleven (3%) of 340 patients with hepatocellular carcinoma (HCC) presented with obstructive jaundice. The tumor extensively infiltrated the major bile ducts in eight patients. Jaundice was relieved by endoscopic endoprosthesis in four patients, nasobiliary drainage in two patients, percutaneous transhepatic stenting in one patient, and surgical intubation in one patient. The survival interval of these eight patients (mean +/- SD) was 35 +/- 20 days. Three patients had tumor fragments in the common bile ducts. In two patients, major hepatic resection was done after initial tube decomposition of the biliary system. One patient remained tumor-free on follow-up at 24 months, and the other patient had recurrent tumor detected on follow-up at 17 months after surgery. The tumor was irresectable in the third patient. Multiple surgical and endoscopic procedures kept the bile duct patent for 17 months before the patient died of the disease. Not all patients who present with obstructive jaundice due to HCC are terminally ill. With proper management, good palliation and occasional cure are possible.
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PMID:Management of hepatocellular carcinoma presenting as obstructive jaundice. 216 29

Death from hepatocellular carcinoma (HCC) is often heralded by the appearance of jaundice which is usually the result of extensive parenchymal damage from either progressive cirrhosis or diffuse tumour infiltration. In rare cases, patients with HCC may present with obstructive jaundice caused by migrated tumour fragments in the common bile ducts. We report three such patients. One patient underwent repeated palliative surgical and endoscopic procedures to clear the bile ducts of tumour fragments. He returned to a normal life but finally succumbed to the disease 17 months after diagnosis. Two patients underwent major hepatic resection after initial tube decompression of the obstructed bile ducts. One patient was found to have recurrence of the tumour 17 months after surgery and the other patient was well and disease-free 24 months after surgery. It is important to recognize and treat this group of patients with migrated tumour fragments in the common bile ducts, as good palliation and occasional cure are possible.
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PMID:Migrated tumour fragments in common bile ducts from hepatocellular carcinoma. 217 52

We present a patient with hepatocellular carcinoma causing obstructive jaundice due to intraductal growth, diagnosed intraoperatively by cholangiography and histological examination, and radically treated by left lobectomy, extrahepatic biliary tract resection and Roux-en-Y hepaticojejunostomy. Survival after operation was 13 months. Other similar cases reported in the literature are reviewed.
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PMID:Obstructive jaundice due to hepatocarcinoma with intraductal growth. Report of a successful resection. 217


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