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 53-year-old man with an arteriovenous malformation of the pancreas associated with extensive mesenteric varices, liver cirrhosis, and hepatocellular carcinoma with arterioportal shunting was diagnosed by angiography. This is the first report of such a case with portal hypertension.
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PMID:Arteriovenous malformation of the pancreas associated with mesenteric varices: case report and review of the literature. 254 33

Eighty cases of endoscopic injection sclerotherapy for esophageal varices were retrospectively studied to evaluate their prognoses. These cases were evaluated in terms of post-therapeutic bleeding, survival rates and causes of death. Post-therapeutic bleeding occurred in 50% of the emergency cases (26 cases), 25% of the elective cases (16 cases) and 23.7% of the prophylactic cases (38 cases). The frequency of post-therapeutic bleeding was significantly lower in cases with variceal obliteration than in cases without obliteration. An evaluation of the survival rates by the Kaplan-Meier method revealed that poor prognostic factors in sclerotherapy cases were emergency cases, Child's C group, post-therapeutic cases with unsuccessfully obliterated varices, and cases with post-therapeutic bleeding. Concerning early death within 7 days after sclerotherapy, 4 emergency cases died from initial variceal bleeding despite sclerotherapy. Three of these 4 were hepatocellular carcinoma cases, and all 3 cases had tumor thrombi of the portal vein. We recommend prophylactic sclerotherapy from the standpoint of the prognosis after sclerotherapy. However, in the bleeding cases of hepatocellular carcinoma in Child's C group complicated by tumor thrombi of the portal vein, overly enthusiastic application of the therapy should be avoided.
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PMID:A prognostic evaluation of endoscopic intravariceal injection sclerotherapy for esophageal varices. 278 59

Among more than 450 hepatectomies performed in the National Cancer Center Hospital of Tokyo from the beginning of 1977 to the end of 1986, 204 were performed for excision of an hepatocarcinoma on cirrhotic liver. The post-operative mortality (determined until the exit of the patient out of the hospital) was 7.8%. It was rather high at the beginning (20% of the first 30 cases) and progressively decreased with experience, to be only 2.8% of the last 70 cases. According to this experience the authors recommend a decisional diagram which appreciate the quantity of functional liver parenchyma which must be resected (depending on the tumor's characteristics) and the quantity of functional liver parenchyma which can be resected without major operative risk (depending on the gravity of the cirrhosis). They expose their attitude with oesophageal varix, the operative techniques and the peri-operative cares they have trained to decrease dramatically the post-operative complications.
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PMID:[Hepatectomy for hepatocarcinoma on a cirrhotic liver: decision plans and principles of perioperative resuscitation. Experience with 204 cases]. 282 12

Ten patients with both hepatocellular carcinoma (HCC) and esophageal or esophagogastric varices were concurrently treated by partial hepatic resection and distal splenorenal shunt. All the patients were men aged from 45 to 71 years. Four patients had had recent episodes of variceal bleeding. Six patients were considered to be at high risk for bleeding, as their varices were large and had "red color signs" endoscopically. Liver cirrhosis was associated with all cases. The grade of hepatic dysfunction was Child A in seven and Child B in three patients. As the HCCs were relatively small, partial wedge hepatectomy was carried out in all patients. Five patients underwent the original Warren shunt, but the remaining five had modified shunts with expanded polytetrafluoroethylene (Gore-Tex) interposition. There was no operative mortality within one month. Nine patients with patent shunts had no variceal bleeding despite the fact that three of them had tumor recurrence in the liver. Hepatic encephalopathy occurred transiently in only one instance. Six patients were alive at the time this report was written, eight to 49 months after operation. Five were free of cancer and one had tumor recurrence. This result may indicate that relatively small HCCs and esophageal varices can be simultaneously treated by limited hepatic resection and distal splenorenal shunt in patients with Child A or B liver disease.
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PMID:Concurrent treatment of hepatocellular carcinoma and esophageal varices by hepatic resection and distal splenorenal shunt. 283 50

Patients with cirrhosis present a continuing diagnostic and therapeutic challenge. The status of their disease frequently changes, necessitating intensive serial evaluation. CT is an invaluable tool in the management of these patients because it can noninvasively provide vital information concerning liver size, contour, and occasionally hepatic parenchyma. More importantly, CT can demonstrate superficial and deep varices, assess the patency of the extrahepatic portal system, and detect other complications including ascites, hepatic steatosis, hemochromatosis, and hepatocellular carcinoma.
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PMID:Computed tomography in the evaluation of cirrhosis and portal hypertension. 298 57

This report describes 53 patients with hepatocellular carcinoma (HCC) complicated with esophageal varices. Esophageal varices were due to cirrhosis of the liver in all cases. Hepatic resection and blocking operations such as Sugiura procedure, transabdominal esophageal transection or Hassab's operation were performed for the treatment of HCC and esophageal varices in 6 cases with satisfactory results. Non-operative treatments such as TAE or arterial infusion chemotherapy for HCC and blocking operations for esophageal varices were performed in 17 cases. Late deaths were recognized in 10 cases. Causes of late deaths were carcinoma of the liver in 7 cases and ruptured varices in only 1 case. In 13 cases with severe hepatic failure, only endoscopic sclerotherapy was performed for the treatment of esophageal varices. However 8 cases of 13 had rebleeding from esophageal varices and died after sclerotherapy. We concluded that effective treatments for HCC complicated with esophageal varices were to perform both the hepatic resection and the blocking operation and these treatments prolong the long-term survival of patients with HCC with esophageal varices.
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PMID:[Treatment of hepatocellular carcinoma with esophageal varices]. 300 59

A 48-year-old man with hepatocellular carcinoma (HCC) showing tumor emboli in the portal vein and a typical retrograde metastasis via the portal vessels, is reported. Metastatic lesions were localized only in the veins of the lesser omentum, stomach, lower esophagus, pancreas, left hemidiaphragm and left adrenal gland, due to the hemodynamic alteration of the portal blood flow caused by liver cirrhosis and HCC. No metastatic lesion was found in the lung, Kidney, bone or intestine. As gastric metastasis Borrmann I, II, III and submusal tumor types were reported, but the present case revealed hard fold-like lesions, as it were, hard white varices.
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PMID:[Retrograde metastasis of hepatocellular carcinoma with an interesting lesion of the stomach--a case report]. 300

Histological examination of the wall of the stomach and esophagus in patients with hepatocellular carcinoma associated with cirrhosis demonstrated intravariceal tumor thrombi in 13 (23.6%) of 55 cases studied. There were distant hematogenous metastases in 31 of them, of whom 12 (38.7%) had variceal tumor thrombi. Tumor thrombi were of varying sizes, and tumor cells appeared either intact, degenerated or necrotic. In seven cases, there was a firm adhesion of thrombi onto the vascular wall suggesting possible mural infiltration, but no extravascular metastases were noted grossly. These findings suggest a possibility of metastasis of hepatocellular carcinoma to the stomach and esophagus via the portal vein. It is also suggested that the degree of varices is not increased by tumor thrombus formation per se, and that both varices and tumor thrombi are due to extensive hepatofugal collateral circulation. Considering that 12 of 13 cases of intravariceal tumor thrombi had lung metastases, a portal vein-varices-lung route is possible for lung metastasis beside the established route through the hepatic vein in hepatocellular carcinoma.
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PMID:Frequency and significance of tumor thrombi in esophageal varices in hepatocellular carcinoma associated with cirrhosis. 301 30

With an increasing number of patients with advanced liver cirrhosis, the discrepancy between the preoperative examination and results of surgery for bleeding varices is widening. To correct this discrepancy, additional prognostic examinations to Child's criteria and routine hepatic laboratory tests were studied in our 246 cirrhotic patients with esophageal varices. These included wedged hepatic vein pressure, clearance and maximal removal rate of indocyanine green, and hepaplastin test. We performed the endoscope assisted terminal esophagoproximal gastrectomy with the EEA stapler gun with devascularization and splenectomy. No operative death and complications developed when the results of following 4 preoperative examinations were: wedged hepatic vein pressure below 400 mm of saline, peripheral disappearance rate (K) of indocyanine green above 0.04 min-1, maximal removal rate (Rmax) of the dye above 0.3mg/kg/min and hepaplastin test more than 40%. It is necessary for these indicators to be satisfied simultaneously prior to performing this surgery. In addition, these values should be changed a little in their critical limits when these cirrhotic patients also had hepatoma and were candidates for hepatectomy.
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PMID:[An analysis of prognostic examination in cirrhotic portal hypertension and hepatoma]. 301 12

Variceal bleeding is a catastrophic event in the history of liver cirrhotics. However, in more than half of the patients it never occurs. Thus, measures to prevent bleeding should be undertaken only in patients at the highest risk of bleeding. Risk indicators should help to select those patients. Hemodynamic and endoscopic parameters as well as liver function and coagulation status and the patient's history have been studied in relation to the bleeding incidence. The following parameters are correlated with an increased bleeding risk: The first year after diagnosis of varices, a positive history of variceal bleeding, presence of varices with large diameters, high blood pressures or a red colour sign, concomitant gastric varices or development of a liver cell carcinoma. Other parameters may be of less importance for the occurrence of variceal bleeding.
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PMID:Risk indicators of variceal bleeding. 305 14


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