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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four patients with oral contraceptive associated hepatic adenoma have been studied and the literature reviewed. Clinically, these patients can be divided into ruptured and nonruptured hepatoma groups. In instances of ruptured hepatomas, resection only sufficient to control hemorrhage definitely is recommended. In instances of nonruptured hepatomas, major resection should only be attempted by skilled surgeons, and small multiple lesions should be observed. These management principles will deserve re-evaluation as more experience with these tumors accumulates. Until then, a conservative approach is indicated. This includes the avoidance of oral contraception until the biochemistry of these tumors is better clarified.
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PMID:Proper management of hepatic adenoma associated with oral contraceptives. 6 62

Three patients with primary hepatic tumours were treated by selective arterial embolisation with gelatin-foam fragments to induce necrosis. In the two with histologically proved hepatocellular carcinoma ultrasonography suggested that necrosis had been induced, as did the rapid initial falls in serum alpha-fetoprotein concentration by 95 and 81% of the original values respectively. Treatment was continued with a course of adriamycin, and both patients remained well and symptom free at 10 and 12 months. In the third patient, who had an expanding and highly vascular benign hepatic adenoma associated with use of a contraceptive pill, embolisation obliterated the tumour mass. Tumour embolisation should be regarded as only the first step in managing hepatocellular carcinoma and as a means of reducing appreciably the viable tumour mass before chemotherapy. It may be used as the primary and definitive treatment in patients with benign liver tumours.
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PMID:Non-operative arterial embolisation in primary liver tumours. 8 83

Case reports of benign hepatoma in young women taking oral contraceptives (OCs) are known to exist. A benign hepatic adenoma was discovered in a young woman who had been taking an OC (Ortho-Novum 2) for 7 years. Although hepatic adenoma is a rare tumor, the increasing number of reports of its occurrence strongly suggest an association between OCs and benign hepatic adenoma. Diagnosis must be suspected in any young woman taking OCs and developing signs of acute cholecystitis with hepatomegaly or mass, or presenting with signs and symptoms of nontraumatic intraabdominal hemorrage. Rupture of the tumor is life-threatening. Treatment should be removal of the tumor whenever possible.
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PMID:Benign liver cell adenoma associated with use of oral contraceptive agents. 17 59

Between 1970 and 1978, eight hepatic adenomas were resected. Four of the eight patients took oral contraceptive pills before the hepatic adenoma was identified; one patient was male. Four patients had evidence of bleeding at the time of presentation. The original histologic diagnosis in the first five patients was malignant hepatoma. There has been no known recurrence of tumor and all patients are well. The use of oral contraceptives in these patients has been prohibited. Formal anatomic resection is recommended for hepatic adenoma when this procedure can be done without mortality or serious morbidity; however, in the future, less drastic treatments, such as occlusion of the hepatic arterial circulation to the tumor or discontinuation of oral contraceptives, may prove as effective as tumor resection.
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PMID:Liver resection for hepatic adenoma. 21 27

Six female patients seen at Groote Schuur Hospital between 1973 and 1977, with the types of liver lesion that have been linked aetiologically with the contraceptive pill, are described. Four had focal nodular hyperplasia (1 with spontaneous rupture), and 1 patient had a hepatocellular carcinoma. The sixth patient had spontaneous rupture of the liver but no tumour was demonstrated. Based on this experience and a review of the literature, controversies in aetiology, diagnosis and managment are presented. A defined management policy is proposed for the benign lesions, a less aggressive approach being advocated for focal nodular hyperplasia than for hepatic adenoma.
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PMID:Liver tumours and the contraceptive pill: Controversies in aetiology, diagnosis and management. 22 76

Amongst 17 patients with hepatic focal nodular hyperplasia (FNH) encountered at Westmead Hospital between 1981 and 1990, FNH was found in association with hepatocellular carcinoma (HCC) in three (3/17), one male and two females, one of whom also had peliosis and an hepatic adenoma. FNH was also found in association with other conditions which may affect hepatic function, structure or circulation, including chronic obstructive airways disease (2), congestive cardiomyopathy (1), chronic active hepatitis (1), granulomatous hepatitis (1), coeliac artery stenosis (1) and metastatic malignant melanoma (1). This report, derived from our experience with FNH over 10 years draws attention to a possible link between FNH, hepatic malignancy and conditions which may disturb the hepatic circulation. We suggest that patients with FNH should be investigated thoroughly and an aggressive management policy should be adopted.
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PMID:Hepatic focal nodular hyperplasia: a benign incidentaloma or a marker of serious hepatic disease? 132 5

Cysts and haemangiomas, which are frequent benign tumours of the liver, must be separated from hepatic adenoma and focal nodular hyperplasia. The former are usually diagnosed by ultrasonography and/or computed tomography (CT), and they exceptionally require surgery. The latter, much rarer, are similar in that both occur in young women and have the same imaging characteristics: CT does not always show the sign that confirms the diagnosis of focal nodular hyperplasia (i.e. a central "scar" vascularized at CT-angiography); scintigraphy would provide the diagnosis, but it is at fault in 30 to 40% of the cases. Excluding a malignant tumour (hepatocellular carcinoma or fibrolamellar hepatocarcinoma) is sometimes difficult. Often more than a certainty, it is a collection of convergent clinical and radiological data that leads to the correct diagnosis.
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PMID:[Benign tumors of the liver. Clinical and radiological data]. 133 30

The benign tumors hepatic adenoma and focal nodular hyperplasia are compared in their etiology, differential diagnosis, risk of transformation, and management. Hepatic adenomas range in size from 1-30 cm, averaged 8-10 cm in diameter, contain vacuoles and glycogen, but no Kupfer cells or bile ducts. Adenoma is usually symptomatic, causing pressure or hemorrhage. The risk of developing adenoma is increased with duration of oral contraceptive use, and chance of a larger tumor, a hemorrhage and mortality during pregnancy or surgery is also increased in pill users. Adenoma also occurs in people with Type Ia glycogen storage disease, and is associated with insulin-dependent diabetes. Often stopping oral contraceptives will cause an adenoma to regress. If not, It is best managed by elective resection, with 1% mortality, rather than 5-10% mortality due to spontaneous rupture. Adenomas can progress to adenomatosis, which are inoperable, or malignant transformation. Focal nodular hyperplasia is marked by a stellate scar, sometimes accompanied by hemangioma, but is asymptomatic. It is not increased in oral contraceptive users, but occurs in older women. It can transform to fibrolamellar hepatocellular carcinoma. The 2 benign lesions can be distinguished by radionuclide scanning and angiography. Only fine needle aspiration is advised for biopsy, because of the risk of hemorrhage with adenoma. Focal nodular hyperplasia takes up radionuclide, stains intensely on angiography, and is safe to biopsy percutaneously.
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PMID:Hepatic adenoma and focal nodular hyperplasia. 165 55

In March 1989, ultrasonography revealed a hepatic mass in a 40 year old nulliparous woman who was then referred to the University of Southern California--Los Angeles (UCLA) Liver Unit. She exhibited no symptoms of a liver condition. From 19-28 years old, she took the combined oral contraceptive (OC) Ovulen 21 for irregular menses. After a brief period of taking Ortho Novum 1/80, she took Demulen 1/35-24 between ages 28-34. Her physician diagnoses endometriosis at 34. He stopped OC therapy and prescribed the progestin Norlutate. She had no history of hepatitis, toxin exposure, and previous liver disease. Further no one in her family had had liver disease or neoplasms. Computer tomography identified a 6.5 cm x 3.5 cm mass in the right lobe of the liver which matched a cold defect on a liver scan using technetium Tc 99m sulfur colloid. The mass selectively took up gallium. Arteriography revealed the mass to be a vascular tumor, but it did not exhibit a typical vascular pattern of an adenoma or the neovascularity of hepatocellular carcinoma. Physicians at UCLA used peritoneoscopy to take percutaneous needle biopsies of the right lobe which confirmed a hepatic adenoma. they then removed the right lobe of the liver. The remaining part of the liver was normal. Histologic examinations of the removed section showed features of a well differentiated hepatocellular carcinoma. Further tumor cells had invaded normal hepatic parenchyma. The physicians believed that hepatic adenoma was in the process of transforming into hepatocellular carcinoma in this patient. They thought that long term OC use, and possibly long term progestin use, may have contributed to the formation of the liver neoplasms. They emphasized the need for a pilot study to develop guidelines on surveillance ultrasonography of women taking OCs over a long period.
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PMID:Hepatocellular carcinoma coexisting with hepatic adenoma. Incidental discovery after long-term oral contraceptive use. 166 98

Either CT or MRI can be used as a primary screening test for liver masses in a patient with a known or suspected malignancy. A number of variations in techniques are available for both CT and MRI, and combinations of these techniques are often required to increase the detectability rate for hepatic lesions. Whether CT or MRI is chosen as an initial screening technique depends upon the particular patient and the institution. After a liver lesion has been identified, attempts should be made to obtain a specific diagnosis. Certain liver masses may have a specific CT appearance, especially when they are calcified. With some benign lesions a specific diagnosis is possible using imaging techniques, and in these instances CT and a supplemental radionuclide study may be of complimentary value. These include cavernous hemangioma, focal fatty liver, and focal nodular hyperplasia. Another group of lesions have a CT or an MRI appearance that is suggestive for a specific diagnosis, but may require confirmation with a biopsy or other tests. These include hepatoma, which may present as a mass with portal vein thrombosis, hepatic adenoma, which may appear as a mass with central hemorrhage, focal nodular hyperplasia may occur as a mass with a central stellate scar (on CT), or a cavernous hemangioma, which fulfills specific CT or MRI criteria. A final group of lesions consists of masses without a characteristic or suggestive CT or MRI appearance. These lesions will require biopsy for final diagnosis.
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PMID:Imaging primary and metastatic cancer of the liver. 201 95


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