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)

We report a case of ectopic hepatocellular carcinoma arising in the bile duct. A 72-year-old woman was transferred to our hospital with fever, abdominal pain, and jaundice. Contrast-enhanced computed tomography revealed a round mass, measuring 25 mm in diameter, in the bile duct. The mass was causing obstructive jaundice. Endoscopic retrograde cholangiography showed a 27 mm x 21-mm round defect in the superior bile duct. These findings led to a diagnosis of bile duct tumor, and the patient underwent extrahepatic bile duct resection and biliary reconstruction. Gross examination of the tumor showed a fibrous capsule and a stalk arising from the bile duct mucosa. The tumor was diagnosed histopathologically as well-differentiated hepatocellular carcinoma arising in the bile duct.
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PMID:Ectopic hepatocellular carcinoma arising in the bile duct. 1599 18

Hepatocellular carcinoma is a neoplasm with a uniformly poor prognosis. Risk factors for its development include chronic hepatitis B or C infection, haemochromatosis and alpha-1-antitrypsin deficiency, but individuals with any type of chronic liver disease are predisposed. The incidence is significantly higher in Asia and Africa although it has been noted to be increasing in the United States. We present a patient with notable atypical clinical features for hepatocellular carcinoma. The patient had neither predisposing risk factors nor a primary liver lesion causing obstructive jaundice. After multiple tissue specimens were obtained, the final pathological diagnosis was established. Hepatocellular carcinoma generally requires a surgical cure, but patients who are icteric often portend poorer prognoses. For those at high risk, screening may be indicated to identify early curative treatment.
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PMID:Extra-hepatic hepatocellular carcinoma presenting as obstructive jaundice. 1624 9

A 70-year-old man was admitted to our hospital with obstructive jaundice. Computed tomography revealed a tumor in the left intrahepatic bile duct extending to the common bile duct without any significant lesions in the liver. Cholangiography showed a filling defect due to an intraductal tumor. Cytology of the bile juice was negative and tumor markers were carcinoembryonic antigen 5.7 ng/ml, carbohydrate antigen 19-9 49 U/ml, alpha-fetoprotein 9 ng/dl, and PIVKA-II 19 200 AU/ml. With a preoperative diagnosis of hilar bile duct carcinoma, a laparotomy was performed. The common bile duct was filled with a tumor and it extended into the bilateral intrahepatic bile ducts. The intraductal tumor was removed together with the extrahepatic bile ducts. An intraoperative histological examination of the tumor showed a well-differentiated hepatocellular carcinoma. No lesions were detected in the liver by ultrasonography, palpation during the operation, or a computed tomography scan after the operation. At 1 year postoperatively, no recurrence has been seen in this patient.
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PMID:An icteric type hepatocellular carcinoma with no detectable tumor in the liver: report of a case. 1679

Obstructive jaundice is uncommon in patients with hepatocellular carcinoma. It can be due to compression of the common bile duct by the liver tumor or by enlarged lymph node metastases in the porta hepatis. Obstructive jaundice can also be due to direct extension of hepatocellular carcinoma into the bile ducts with or without a detectable primary hepatic tumor. These particular hepatocellular carcinoma have been termed "icteric type hepatoma" by Lin et al. in 1975, who emphasized their poor prognosis. We report a similar case of endobiliary hepatoma without a detectable intraparenchymal hepatic tumor in a seventy year-old man. This case is unusual because of its positive evolution and late recurrence.
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PMID:[Delayed recurrence of an endobiliary hepatocellular carcinoma without detectable intra-parenchymatous tumor]. 1680 6

The Authors take a hint from recent observation of two patients with hepatocellular carcinoma presenting with obstructive jaundice to analyse the litterature and their clinical cases. They conclude that in the evolution of hepatocellular carcinoma can be found "early" or "late" jaundice. The latest is hepatocellular and/or obstructive jaundice and it is harbinger of fatal prognosis because of a big hepatocelluar carcinoma that has invaded biliary tree and/or liver failure by concomitant cirrhosis. The "early" jaundice appears when the tumor is still small and it is always obstructive due to intrabile duct tumor growth. This kind of jaundice has a good prognostic meaning because, together with imaging techniques, permits an early diagnosis of the hepatocellular carcinoma necessary for satisfactory palliation or occasional cure.
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PMID:[Obstructive jaundice caused by hepatocellular carcinoma]. 1682 15

To observe the effects of Danshen on the growth of hepatocellular carcinoma in the SD rats, a model of malignant obstructive jaundice was established by inoculation of transplanted tumor into the hepatic portal with the walker-256 hepatocarcinoma line, which resulted in the obstruction by the infiltration and metastasis of hepatocellular carcinoma. SD rats were divided into 4 groups: the rats were treated by 0.9 % NS (n=24, control group), inosine+vitamin C (n=40, InV group), Danshen (n=40, DS group) and 5-FU (n=40, 5-FU group), respectively. The liver function, morphological changes and the expressions of PCNA, VEGF and ICAM-1 in carcinoma foci, peri-carcinoma tissues, adjacent lobe (left-internal lobe) and lung tissues were observed after the treatment with the 4 agents. Our results showed that the protective effect of Danshen on liver function was significantly better than that of NS and 5-FU (P<0.01). No significant difference in protective effect was observed between DS group and InV group (P>0.05). Danshen also provided protective effect on the morphological damage of liver caused by obstructive jaundice. The rates of carcinoma-inhibition and metastasis inhibition were significantly higher than those of NS and inosine+vitamin C (P<0.01). No significant difference in this regard existed between DS group and 5-FU group (P>0.05). The expressions of PCNA,VEGF and ICAM-1 PCNA, VEGF and ICAM-1 in carcinoma foci, peri-carcinoma tissues, adjacent lobe (left-internal lobe) and lung tissues were lower than those in control group and InV group, with the differences being significant (P<0.01). No significant differences were found between DS group and 5-FU group in the expression levels of PCNA and VEGF (P>0.05) but ICAM-1 (P<0.05). It is concluded that Danshen injection not only has protective effects on liver injury caused by obstructive jaundice, but can inhibit the proliferation and growth of hepatocarcinoma, interfere with the vascularization of tumors, prevent recurrence and metastasis of hepatocarcinoma.
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PMID:Effects of Danshen injection on the malignant obstructive jaundice in the SD rat model. 1735 89

As part of the multifactorial role of liver in protein synthesis, many coagulation factors, natural anticoagulants, and compounds of the fibrinolytic system are produced in the liver. A prolonged liver disease, either biliary obstruction or parenchymal liver disease, is consecutively accompanied by abnormal clotting. In the present paper we review the haemostasis impairment in obstructive jaundice with special reference to the hepatic cirrhosis and failure, to systemic inflammation and sepsis that develops in cholestatic diseases, and finally in some other benign or malignant diseases including pancreatic adenocarcinoma, acute pancreatitis, cholangiocarcinoma, and hepatocellular carcinoma. Finally, a special reference to the possible therapeutic interventions has been made. The aim of the present review is to collect the current concepts concerning the haemostasis impairment in obstructive jaundice and provide practical guidelines for the diagnostic and therapeutic strategies. Understanding the pathophysiology of haemostatic changes in patients with cholestasis, and, more generally, liver disease, is the hallmark of accurate diagnosis and treatment.
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PMID:Haemostasis impairment in patients with obstructive jaundice. 1759 68

A 73-year-old Japanese male, who had a history of alcoholic cirrhosis, was admitted to Saga University Hospital to receive treatment for hepatocellular carcinoma. The patient was treated to maintain his liver function, however, the total bilirubin level continued to increase gradually. Endoscopic retrograde cholangiography demonstrated an obstruction of the bilateral intrahepatic ducts. Although endoscopic nasobiliary drainage was performed, the patient died two months after admission. At the autopsy, multiple peribiliary cysts were found to almost completely obstruct the bilateral intrahepatic bile ducts. In addition, hepatolithiasis was found in the right hepatic duct. To date, only a few such cases of multipleperibiliary cysts with obstructive jaundice have been reported, and no such case accompanied by hepatolithiasis. It is also important to note that all the reported cases resulted in a poor prognosis. We herein report a very rare autopsy case with obstructive jaundice due to multiple peribiliary cysts accompanying hepatolithiasis. Generally, multiple peribiliary cysts are considered to be clinically harmless, but once they cause obstructive jaundice, their presence suggests the occurrence of end-stage cirrhosis and a poor prognosis.
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PMID:An autopsy case of obstructive jaundice due to hepatic multiple peribiliary cysts accompanying hepatolithiasis. 1764 17

A 70-year-old man was admitted to our hospital with obstructive jaundice. We performed a laparotomy. The intraductal tumor was removed with the extrahepatic bile ducts. A histological examination of the tumor showed an icteric type hepatocellular carcinoma. The recurrent tumor was detected as intrajejunal tumor thrombi by a CT scan. No lesions were detected in the liver by a CT scan, ultrasonography, and angiography. We performed the second laparotomy. The tumor thrombi in jejunal limb were removed. At 2 months after the operation, an intrahepatic lesion and tumor thrombi were detected. TACE were performed two times and the response was CR. At 16 months after the operation, no recurrence has been seen in this patient.
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PMID:[An icteric type hepatocellular carcinoma with no detectable tumor in the liver but with an intrabile duct recurrent tumor]. 1821 11

Selective internal radiation (SIR) therapy using 90yttrium microspheres is effective for treating selected cases of unresectable liver malignancies with little morbidity. We herein report two cases illustrating a very rare complication of SIR. A 68-year-old patient with inoperable recurrent hepatocellular carcinoma received one treatment of SIR with 90yttrium microspheres and 4 months later presented with obstructive jaundice. Percutaneous transhepatic cholangiography revealed diffusely dilated intrahepatic ducts with multiple biliary strictures. Hepatic angiography showed normal hepatic arterial branches with no evidence of vascular insufficiency. Liver biopsy finally revealed cholestasis, cholangitis, and fibrosis, consistent with radiation-induced damage. Another 56-year-old patient with unresectable colorectal liver metastases presented with cholangitis 4 weeks after SIR. Ultrasonography showed no biliary dilatation, and endoscopic retrograde cholangiopancreatography demonstrated a normal biliary tree. Liver biopsy subsequently confirmed radiation-induced cholangitis.
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PMID:Biliary complications associated with selective internal radiation (SIR) therapy for unresectable liver malignancies. 1832 Mar 7


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