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

A 50-year-old male patient was admitted to the hospital for persistent high fever and back pain. He was diagnosed with hepatocellular carcinoma (HCC), bone marrow metastasis and disseminated intravascular coagulation (DIC). Despite the diagnosis and treatment, the general condition deteriorated rapidly and he died of cerebral hemorrhage associated with generalized bleeding tendency. Autopsy showed multiple HCC in the liver and systemic metastasis including bone marrow. The case describes a rare complication of HCC with disseminated carcinomatosis of the bone marrow (DCBM) complicated with DIC, with rapid deterioration and death. This is the first case of DCBM from HCC. Physicians need to be aware of DCBM in patients with HCC.
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PMID:Disseminated carcinomatosis of the bone marrow originating from hepatocellular carcinoma. A case report. 2504 22

We previously generated a group I intron-based ribozyme that can reprogram human telomerase reverse transcriptase (hTERT) RNA to stimulate transgene activity in cancer cells expressing the target RNA via an accurate and specific trans-splicing reaction. One of the major concerns of the hTERT RNA targeting anti-cancer approach is the potential side effects to hTERT(+) hematopoietic stem cell-derived blood cells. Thus, here we modified the ribozyme by inserting target sites against microRNA-181a, which is a blood cell-specific microRNA, downstream of its 3' exon. The specificity of transgene induction and anticancer activity in hTERT(+) cancer cells improved significantly with the modified ribozyme, resulting in selective targeting of hTERT(+) cancer cells, but not hematopoietic cells even if they are hTERT-positive. Importantly, the trans-splicing reaction of the microRNA-regulated ribozyme worked equally well in a nude mouse model of hepatocarcinoma-derived intrasplenic carcinomatosis, inducing highly specific expression of a therapeutic transgene and efficiently regressing hTERT-positive liver tumors with minimal liver toxicity when systemically delivered with an adenoviral vector encoding the ribozyme. These results suggest that a combined approach of microRNA regulation with targeted RNA replacement is more useful for effective anti-cancer treatment.
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PMID:Targeted anticancer effect through microRNA-181a regulated tumor-specific hTERT replacement. 2544 4

Peritoneal carcinomatosis from hepatocellular carcinoma is well regarded as a poorly treatable malignant disease with rapid decline. Over the past decade, new modalities that combine cytoreductive surgery with perioperative hyperthermic intraperitoneal chemotherapy have been shown to be aggressive local-regional treatments with improved survival. We present a case of a 67-year-old non-cirrhotic woman with peritoneal metastases from hepatocellular caracinoma who was treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. Consideration remains individualized, but it can be considered in patients with adequate preservation of liver function, management of their primary hepatocellular caracinoma as well as the localized nature of their peritoneal metastases.
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PMID:Hepatocellular carcinoma with peritoneal metastasis treated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy. 2570 49

Here we reported that association between drug resistance and carcinomatosis in advanced liver cancer cases. All subjects (n=4) were periodically received chemotherapeutic agents when clinical manifestation being defined serologically. Hepatic specimen was harvested via biopsy and further prepared as paraffin-slice before conducting immunohistochemistry. As a consequence, more detectable biomarkers, such as AST, AFP, GGT2, were high expressed in plasma when compared to clinical standards. DNA topoisomerase II (TOPO II), Ki-67 were immunoreactively labeled in cytoplasm/membrane and nucleolus of liver cancer cells, while hepatocellular tumor protein p53 was negative or non-detected. Additionally, we found that hepatobiliary cancer showed epithelial differentiation with pronounced CK19 immunoreactivity when metastasizing. Our clinicopathologic findings demonstrate that correlation between carcinomatous proliferation/metastasis and drug resistance protein expression. Furthermore, these evidences indicate that TOPO II may be a biomarker for advanced hepatocellular carcinoma patient receiving chemotherapeutics.
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PMID:Clinical characterization for proliferation and metastasis in advanced hepatocellular carcinoma patients. 2672 53

BACKGROUND Hyperammonemic encephalopathy is a potentially fatal condition that may progress to irreversible neuronal damage and is usually associated with liver failure or portosystemic shunting. However, other less common conditions can lead to hyperammonemia in adults, such as fibrolamellar hepatocellular carcinoma. Clinical awareness of hyperammonemic encephalopathy in patients with normal liver function is paramount to timely diagnosis, but understanding the underlying physiopathology is decisive to initiate adequate treatment for complete recovery. CASE REPORT A 31-year-old male with fibrolamellar carcinoma and peritoneal carcinomatosis presented with rapid onset hyperammonemic encephalopathy. Despite usual treatment for hepatic encephalopathy, his hyperammonemia was aggravated. A physiopathological pathway to encephalopathy resulting from hepatocellular dysfunction or portosystemic shunting was suspected and proper treatment was initiated, which resulted in complete remission of encephalopathy. Thus, we propose there is a physiopathology path to hyperammonemic encephalopathy in non-cirrhotic patients with fibrolamellar carcinoma independent of ornithine transcarbamylase (OTC) mutation. An ornithine metabolism imbalance resulting from overexpression of Aurora Kinase A as a result of a single, recurrent heterozygous deletion on chromosome 19, common to all fibrolamellar carcinomas, can lead to a c-Myc and ornithine decarboxylase overexpression that results in ornithine transcarboxylase dysfunction with urea cycle disorder and subsequent hyperammonemia. CONCLUSIONS The identification of a physiopathological pathway allowed adequate medical treatment and full patient recovery from severe hyperammonemic encephalopathy.
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PMID:A Proposed Physiopathological Pathway to Hyperammonemic Encephalopathy in a Non-Cirrhotic Patient with Fibrolamellar Hepatocellular Carcinoma without Ornithine Transcarbamylase (OTC) Mutation. 2827 Jun 54

Intrahepatic cholangiocarcinoma (ICC) is a common primary hepatic tumor. However, its outcomes are usually worse than those of hepatocellular carcinoma owing to its non-specific presentation and detection at an advanced stage. The most widely used serum marker, carbohydrate antigen 19-9, is non-specific. Furthermore, imaging studies rarely identify any pathognomonic features. Surgery is the only treatment option that offers a chance of long-term survival. However, the resectability rate is low owing to the high frequencies of intrahepatic metastases, peritoneal carcinomatosis, or extrahepatic metastases. Surgical treatment should be tailored according to the macroscopic classification of ICC (e.g. mass-forming, periductal infiltrating, and intraductal growth types) because it reflects the tumor's dissemination pattern. Although lymph node metastasis is a negative prognostic factor, the importance and extent of lymph node dissection is still controversial. To improve patient survival, liver transplantation is considered in some patients with unresectable ICC, especially in those with an insufficient remnant liver volume. Minimally invasive procedures, including laparoscopic and robotic liver resection, have been tested and achieved comparable outcomes to conventional surgery in preliminary studies. No randomized trials have confirmed the efficacy of adjuvant chemotherapy in ICC, and several trials have evaluated molecular-targeted agents as monotherapy or in combination with cytotoxic chemotherapy. Multidisciplinary approaches are necessary to improve the outcomes of ICC.
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PMID:Multidisciplinary management of intrahepatic cholangiocarcinoma: Current approaches. 2857 20

Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death worldwide. Hepatocellular carcinoma commonly metastasizes to lungs, lymph nodes, and bone. Although HCC usually occurs in setting of chronic liver disease due to alcoholism or HBV/HCV infection, the incidence of HCC arising from nonalcoholic steatohepatitis is increasing. We present a very unusual initial presentation of occult HCC with peritoneal carcinomatosis secondary to liver rupture in a 70-year-old man with known nonalcoholic steatohepatitis-cirrhosis, best appreciated on FDG PET/CT. Our patient died a few days later. Tumor rupture is a rare but usually rapidly lethal complication of HCC.
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PMID:Rapidly Lethal Ruptured Hepatocellular Carcinoma With Disseminated Peritoneal Carcinomatosis on FDG PET/CT. 3116 59

Fibrolamellar carcinoma (FLC) is a rare variant of hepatocellular carcinoma, occurring in children and young adults without underlying liver disease. The diagnosis is based on morphological characteristics of the tumor, supplemented by immunohistochemistry and/or genetic testing. Recently, the presence of a characteristic DNAJB1-PRKACA fusion gene has been associated with FLC. Herein, we report a case of FLC presenting as peritoneal carcinomatosis in a 14-year-old female. Interestingly, no liver tumor was seen on imaging, and an alternative possibility is that the tumor arose outside the liver as a hepatoid carcinoma with fibrolamellar features.
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PMID:DNAJB1-PRKACA-positive metastatic fibrolamellar carcinoma with unknown primary in a pediatric patient. 3173 18


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