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)

A 70-year-old man with homozygous alpha1-antitrypsin deficiency (AATD) (Pi-ZZ phenotype) at tutopsy was found to have a hepatocellular carcinoma and hepatic fibrosis, pulmonary emphysema, and cor pulmonale. Characteristic cytoplasmic inclusion bodies, with identical histochemical and ultrastructural features, were detected in both normal and malignant liver cells. It is suggested that AATD may precede malignancy, since this is the eleventh case report of this association.
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PMID:Alpha1-antitrypsin deficiency--an association with hepatic malignancy. 17 81

Pathological examinations during autopsy of 1457 cases of cancer demonstrated the presence of metastatic pulmonary emboli in 10 p. cent (148 cases). The were divided, as a function of their site and histological type of the primary neoplasm, as follows: hepatoma 33 p. cent, chorioepithelioma 25 p. cent, endocrine glands 19 p. cent, biliary tract 17.6 p. cent, hypernephroma 15.6 p. cent, sarcoma 13 p. cent, and various other tumors such as cancer of the pancreas, and breast. Two anatomical types of these emboli can be distinguished: one mixed type associated with a pulmonary cancerous lymphangitis (90 cases), and observed at a later stage in the disease. This may be latent or cause a subacute cor pulmonale. The other type is not associated with lymphangitis (58 cases), results from hematogenic cancers (hepatoma, hypernephroma, etc...), is often seen at an early stage, and causes sudden death. Histological examination enabled the consequences of any infarct developing as a result of the emboli to be demonstrated, and the origin of the emboli from neoplasmatic thromboses in the primary cancer drainage routes or from metastases in the liver to be determined.
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PMID:[Metastatic pulmonary emboli: clinical types and incidence (author's transl)]. 625 4

A retrospective case-control study of 100 elderly patients admitted to Goroka Hospital was undertaken. Chronic disease with cor pulmonale was the commonest condition diagnosed in this group (22%) and lobar pneumonia was the commonest infection (17%). Cancer occurred in only 5% of subjects, and in all of these patients, hepatocellular carcinoma was diagnosed. No cases of degenerative cardiovascular disease were observed. Mean hospital stay was 12.9 days.
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PMID:Elderly ailing Highlanders of Papua New Guinea. 696 36

To elucidate the relationship between the clinical manifestations and pathologic findings in pulmonary tumor embolism, we reviewed the autopsy and clinical records of 318 patients who died of various cancers, excluding lung cancer. Sixty-seven (21%) of the patients had at least one tumor embolus in the pulmonary arteries and 12 (3.8%) had multiple tumor emboli contributing to death. We considered that the 12 patients (6 with hepatoma, 3 with gastric cancer, and one each with colon cancer, pelvic cancer, and cervical cancer) had disease defined as pulmonary tumor embolism, and we fully analyzed these cases. Patients with hepatoma had manifestations of submassive pulmonary thromboembolism and patients with other cancers had manifestations of pulmonary microthromboembolism. The lungs of all of the 6 patients with hepatoma had both microscopic and macroscopic tumor emboli and 3 cases were accompanied by pulmonary infarction. On the other hand, the lungs of all of the remaining 6 patients had microscopic (including intracapillary) tumor emboli and 4 cases were accompanied by diffuse alveolar damage. The lung of 1 of the patients with hepatoma and 2 of the patients with other cancers also had pulmonary tumor thrombotic microangiopathy. In patients with hepatoma, the tumor emboli seemed to be derived from tumor invasion to large veins, while the tumor emboli seemed to be derived from widespread tumor invasion to lymphatic channels in the remaining patients. The authors conclude that pulmonary tumor embolism shows heterogeneous manifestations such as acute and subacute cor pulmonale and diffuse alveolar damage. Clinicians should keep in mind that the heterogeneity of the disease is closely associated with the varieties of malignancies and their spread.
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PMID:[Pulmonary tumor embolism: relationship between clinical manifestations and pathologic findings]. 827 60

Hepatocellular carcinoma (HCC) can give multiple different initial clinical presentations. To the author's knowledge, however, dyspnea has not yet been recorded as an initial clinical presentation of HCC. A 39-year-old woman who had dyspnea for 2 months because of HCC is, therefore, reported herein. A chest X-ray revealed reticulonodular infiltration of lungs which led to antituberculous treatment. She died 3 months after initial dyspnea. An autopsy demonstrated a HCC, 1.5 x 2 x 2 cm, at the edge of the left lobe of the liver with widespread intravascular metastases to the lungs. The patient, moreover, had hypertrophy of the right cardiac ventricle being compatible with cor pulmonale. These pulmonary and cardiac findings are regarded to have produced dyspnea in this case.
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PMID:Hepatocellular carcinoma having progressive dyspnea as clinical presentation. 899 15

Tumoral pulmonary embolism is among the causes of acute dyspnea in patients with neoplasia. This phenomenon, different to thrombotic embolism, occurs frequently in patients with lung, gastrointestinal, liver, breast and uterus neoplasia. It is usually asymptomatic and usually constitutes an autopsy finding in these patients. More rarely it manifests as a cor pulmonale which evolves subacutely. Exceptionally large tumoral emboli spread from a primary tumoral mass, and obstruct main pulmonary arterial vessels, causing a clinical picture indistinguishable from massive pulmonary thromboembolism. We present case of massive tumoral pulmonary embolism by an hepatocarcinoma. In spite of an early thrombolytic treatment the patient died from acute pulmonary hypertension.
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PMID:[Massive tumorous pulmonary embolism in hepatocarcinoma]. 951 32

Microscopic pulmonary tumour embolism is a rare cause of pulmonary hypertension. In most of the reported cases, symptoms develop over several days or weeks in patients previously diagnosed with malignant diseases. In our case, a 41-year-old man with an unremarkable medical history presented with respiratory failure that led to death less than 48 h from the onset of symptoms. Autopsy revealed massive microscopic pulmonary tumour embolism and a multifocal hepatocellular carcinoma. This case report is exceptional because it describes a very rapid clinical progression, and because acute cor pulmonale was the first manifestation of a previously undiagnosed neoplastic disease.
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PMID:Acute cor pulmonale due to microscopic tumour embolism as the first manifestation of hepatocellular carcinoma. 1216 88

Pulmonary lymphangitic carcinomatosis is a well-documented phenomenon caused by spread of carcinoma to the pulmonary vasculature and lymphatics, often resulting in respiratory failure and cor pulmonale. It has been described in numerous types of carcinoma, most commonly occurring with carcinomas of the breast and stomach and with choriocarcinoma. We report the case of a patient who presented with increasing shortness of breath and dyspnea on exertion. Autopsy findings revealed diffuse pulmonary vascular spread of a hepatocellular carcinoma to the lungs. To our knowledge, this is the first reported case of lymphangitic spread of a hepatocellular carcinoma causing respiratory compromise (lymphangitic carcinomatosis).
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PMID:Lymphangitic spread of hepatocellular carcinoma. 1256 85

Hepatic hydrothorax is defined as pleural effusion with liver cirrhosis but no primary cardiopulmonary disease. Hepatic hydrothorax is often resistant to various therapeutic interventions. The most likely cause is the transfer of ascites fluid from the abdomen to the pleural space via the diaphragm because of a negative intrathoracic pressure gradient. A 62-year-old man was diagnosed with hepatoma and cirrhosis. After a partial hepatectomy, he suffered with hepatic hydrothorax. He had snoring without obvious sleep apnea. The patient's hepatic hydrothorax markedly improved following nasal continuous positive airway pressure (nCPAP) treatment during sleep. The mechanism for the improvement may have been the intrathoracic positive pressure during sleep induced by the nCPAP treatment during sleep. nCPAP treatment may provide a new therapy for resistant hepatic hydrothorax.
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PMID:Resistant hepatic hydrothorax: a successful case with treatment by nCPAP. 1573 99

During the past two decades, orthotopic liver transplantation (OLT) emerged to the treatment of choice for patients with end-stage liver disease. In Switzerland, about 100 liver transplantations are performed every year, while the shortage of cadaveric organs considerably outmatches the demand. Common indications for OLT include cirrhosis due to alcoholic liver disease or chronic viral hepatitis related to hepatitis B or C, and hepatocellular carcinoma. With the advent of the new allocation policy in Switzerland in 2007, patients listed for OLT are mainly stratified based on the Model of End-stage Liver Disease (MELD) score. Using a patient's laboratory values for serum bilirubin, serum creatinin, and the international normalized ratio for prothrombin time (INR), the MELD score accurately predicts three-month mortality among patients on the waiting list. Compared to the pre-MELD era, patients with significantly higher MELD scores undergo transplantation which leads in turn to more complications and higher costs yet with a comparable outcome. Timely referral of potential candidates to a transplant center is crucial since thorough evaluation to rule out contraindications such as uncontrolled infection, extrahepatic malignancy or advanced cardiopulmonary disease is essential. Taken together, every patient presenting with acute liver failure, decompensated cirrhosis or suspected hepatocellular carcinoma should be evaluated in a center with liver transplantation capability.
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PMID:[Liver transplantation - when and for whom it should be performed]. 2213 86


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