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)

Cutaneous metastases from hepatocellular carcinoma are rare. In this report we detail a case of hepatocellular carcinoma with the unusual manifestations of multiple skin metastases. A 49-year-old male, who had received surgical resection of hepatocellular carcinoma one year prior, presented with multiple reddish-blue, firm, painless and nonulcerative cutaneous papules and nodules over the fingers, palms, toes, soles and back. Pathology of the cutaneous nodules showed characteristic hepatocellular carcinoma with trabecular gland formation. These lesions grew very rapidly and developed to cauliflower appearances which had not been described previously in the literature. The patient died of respiratory failure secondary to lung metastasis two months after the first appearance of the skin lesions.
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PMID:An unusual cutaneous metastasis from hepatocellular carcinoma. 1145 65

The diagnostic approaches, mode of therapies, frequencies of distant metastasis and causes of death in 139 patients with hepatocellular carcinoma (HCC) between 1976 and 1998 were studied by dividing the total study duration into three periods. The period between 1976-1980 (period I) was characterized by the absence of periodic follow-up of the patients with chronic liver diseases, and operation was the only therapeutic choice for HCC. During 1981-1986 (period II), periodic screening of patients with chronic liver diseases was started using ultrasonography, and transarterial embolization became a second choice of therapy along with operation. Period III (1986-1998) was characterized by the availability of facilities to make definitive diagnosis of HCC using small-gauge cutting needle biopsy under sonographic guidance. Data from our study show that along with the advancement of new and invasive diagnostic and therapeutic approaches, the frequency of death due to gastrointestinal bleeding decreased, whereas, the frequency of death due to respiratory failure resulting from pulmonary metastasis increased. Patients treated with transcatheter arterial embolization were more prone to develop pulmonary metastasis. These data show that patients with HCC undergoing invasive therapies should be checked for distant metastasis in addition to intrahepatic recurrence of HCC.
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PMID:Chronological changes of causes of death and distant metastasis in hepatocellular carcinoma. 1183 2

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

More procedures used in transection of the liver parenchyma include also resection by means of a harmonious scalpel with an enhanced haemostatic effect. Based on analysis of 51 patients operated on account of liver disease using a harmonious scalpel, the authors evaluate its asset to the liver resection technique. The harmonious scalpel was used in transection of the liver in seven patients with benign liver disease (inborn cysts, follicular nodular hyperplasia, haemangioma, hepatocellular adenoma) and in 44 with malignant disease (hepatocellular carcinoma, metastases, most frequently, i.e. 34x of colorectal carcinoma). Anatomical liver resection (hemihepatectomy, lateral bisegmentectomy, segmentectomy) was implemented in 34 patients, and in 17 a wedge-shaped resection. Transection of the parenchyma by a harmonious scalpel was made using 10 mm coagulation scissors, i.e. their blunt blade with a lower oscillation grade. The preoperative blood loss was from 30 to 300 ml. As to postoperative complications 2 patients developed cholascos, 2 fluidothorax, 1 respiratory failure and 2 early infection. Liver resection by means of a harmonious scalpel is a new method of parenchyma transection with adherence to the resection line without damage of the deeper structures, reducing preoperative haemorrhage and minimalizing the extent of resection in liver diseases with impaired regeneration of the parenchyma (cirrhosis). Liver transection by a harmonious scalpel is a safe method where it is essential to respect recommended technical parameters, incl. the necessary time.
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PMID:[Liver transection with the harmonic scalpel in elective liver surgery]. 1266 83

A 75-year-old man was admitted to our hospital because of severe dyspnea and pollakiuria in October 2001. We diagnosed his illness as carcinomatous pericarditis caused by the recurrence of primary lung cancer and prostatic hypertrophy. He had undergone surgery for gastric cancer in 1986, and for lung cancer in 1996. Furthermore, he had been treated for hepatocellular carcinoma in 1997. He finally died in February 2002 of respiratory failure due to the carcinomatous lymphangitis that followed the lung cancer. After autopsy, a microscopic view of the prostate revealed that he had prostatic carcinoma. Such a case is rare.
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PMID:[A case of quadruple cancer arising in the stomach, lung, liver and prostate]. 1506 83

Previously we reported combined chemo-immunotherapy, using interferon (IFN)-alpha and 5-fluorouracil (5-FU) for patients with advanced hepatocellular carcinoma (HCC), and this regimen improved the prognosis. Recently, we experienced an HCC patient who died of severe interstitial pneumonia during the combined IFN-alpha and 5-FU therapy. This is the first report of the occurrence of interstitial pneumonia during combined IFN-alpha and 5-FU treatment. A 60-year-old-man was admitted to Osaka University Hospital to receive systemic chemo-immunotherapy for recurrent HCC. In the second week of the chemo-immunotherapy, he showed a decreased level of consciousness, and respiratory insufficiency. Emergency roentgenogram revealed diffuse infiltration in both lungs. Respiratory dysfunction due to interstitial pneumonia was suspected, and steroid pulse therapy was started. However, the patient showed respiratory failure, and he died 32 days after the start of the therapy. Autopsy findings showed atelectasis in the bilateral lungs, which showed elastic hard solidity and a dark red color; esophageal varices were also shown, and there was cirrhosis with a large tumor in the liver. Microscopically, the alveolar wall showed marked fibrous thickness and moderate inflammatory change, which is consistent with acute interstitial pneumonia, and the acute pulmonary change was suspected to have been the cause of death. The association of IFN with the development of interstitial pneumonia has been reported. However, the prognosis of IFN-induced interstitial pneumonia has mostly been favorable when the medication was discontinued. It has been postulated that interstitial pneumonia induced by the combination of IFN and 5-FU may be therapy-resistant. The combination of IFN-alpha and 5-FU is a useful therapy for patients with advanced HCC, such as that with portal vein invasion or multiple metastatic foci. Thus, interstitial pneumonia in these patients should be carefully managed.
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PMID:Interstitial pneumonia induced by combined intraarterial 5-fluorouracil and subcutaneous interferon-alpha therapy for advanced hepatocellular carcinoma. 1533 75

The outcome of pulmonary metastasectomy of hepatocellular carcinoma (HCC) was appraised in this study. Twenty patients with pulmonary metastasis from HCCs undergoing pulmonary resection between 1990 and 2003 were included in this study. They had undergone curative treatment for the primary lesion and were candidates for a pulmonary metastasectomy for complete resection. Among the 20 patients, 13 died: 5 from hepatic failure, 5 from respiratory failure, and 2 from brain metastasis due to recurrence of the HCC. One patient died from cardiac failure without HCC recurrence. At the latest observation, three of the seven survivors were doing well without HCC recurrence, and others survived with recurrence. The overall survival rates after the initial lung surgery were 45.3% at 1 year and 23.8% at 3 years, respectively. The survival rates without recurrence were 32.4% at 1 year and 21.6% at 3 years, respectively. A Kaplan-Meier analysis showed that multiple lung surgeries and a negative histologic finding of the liver cut surface were favorable characteristics for survival without recurrence. In conclusion, the selected patients were Candidates for pulmonary metastasectomy after a curative hepatectomy for HCC and could benefit from the complete resection. Also, repeated pulmonary resections through thoracoscopy could result in the long-term survival of patients with pulmonary recurrence of HCC.
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PMID:Appraisal of surgical treatment for pulmonary metastasis from hepatocellular carcinoma. 1607 27

Despite progress in therapy for hepatocellular carcinoma, management of extrahepatic metastatic lesions remains problematic. A 73-year-old man who underwent transcatheter arterial embolization for hepatocellular carcinoma presented bilateral adrenal metastases. Ten months after transcatheter arterial embolization, computed tomography detected huge tumors in both adrenal glands. Simultaneous resection of both adrenal lesions was performed under hydrocortisone replacement therapy. These tumors were confirmed histopathologically to represent adrenal metastatic lesions of hepatocellular carcinoma. The patient died of respiratory failure due to lung metastasis 9 months after adrenalectomy, although intrahepatic tumor was controlled by transcatheter arterial embolization. It is necessary to clarify the therapeutic effectiveness and the indication of adrenalectomy for patients with adrenal metastasis.
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PMID:Surgical management of bilateral adrenal metastases from hepatocellular carcinoma after transcatheter arterial embolization. 1661 86

Intrabronchial involvement by metastatic tumors from extrapulmonary primary sites is referred to as "endobronchial metastasis", which is an uncommon mode of metastasis. Although various primary sites (for example, breast, colon, and kidney) have been reported previously, endobronchial metastasis of hepatocellular carcinoma (HCC) is rare. Here, we report a case of a 71-year-old woman with hepatitis C-related HCC, in whom respiratory failure due to bilateral endobronchial metastasis occurred. Notably, long tree-like tumor shadows reminiscent of the structure of the bronchial tree were observed in the bilateral lungs on computed tomography scan, and postmortem analysis clearly revealed metastatic HCC growing and spreading extensively in the lumina of the bronchi. This growth pattern is in sharp contrast to the ordinary endobronchial metastasis, which involves a relatively short segment of the unilateral bronchus. This is the first case report of bilateral and extensive spreading of endobronchial metastatic HCC, and this phenomenon should be considered as a cause of dyspnea in advanced HCC patients.
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PMID:Extensive endobronchial growth of metastatic hepatocellular carcinoma resulting in respiratory failure: a case report. 1936 34


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