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)

Forty-two cases of ruptured hepatoma with intra-abdominal haemorrhage were seen over a period of eight years in the professorial surgical unit at the Queen Mary Hospital, Hong Kong. In all, 207 cases of liver cancer were seen during this period, giving an incidence of rupture of 14.5%. There were 37 men and five women. The clinical features were the sudden onset of pain with shock and the presence of blood in the peritoneal cavity. The diagnosis was made before operation on suspicion and by a process of elimination. In cases of doubt paracentesis abdominis was performed to determine whether there was blood in the peritoneal cavity. Treatment was directed to control of haemorrhage and resection.The prognosis, although extremely poor, is no worse than the hepatocellular carcinoma that has not ruptured. There was one long-term survivor-a patient who had undergone an extensive resection. The man was alive and well after more than five years.
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PMID:Spontaneous rupture of hepatocellular carcinoma. 434 61

Benign liver tumors are relatively uncommon and, even when large enough to be symptomatic, they usually remain undiagnosed prior to exploratory laparotomy. Hemangiomas constitute the majority of benign hepatic neoplasms and are 9 times as frequent in females as in males. Most are asymptomatic but abdominal swelling, a mass, or symptoms due to compression of adjacent organs may occur and abdominal hemorrhage is reported in 4.5% of patients. Hepatic hemangioma may produce a large arteriovenous communication serious enough to cause heart failure. Recently an increased frequency of liver tumors, mostly adenomas, has been noted in women taking oral contraceptives (OCs); the cause has been attributed to estrogens. The exact incidence is unknown but believed to be low. It is most common in women in their late 20s who have been on OCs for 7 years or more. The tumor occasionally completely regresses on withdrawal of the OCs. The tumor may be discovered incidentally at laparotomy or may manifest inself by pain, a palpable mass, or catastrophic hemoperitoneum. Hepatic adenoma is usually a solitary lesion and infrequently degenerates into malignancy. Differential diagnosis includes chronic gall bladder disease and peptic ulcer. Focal nodular hyperplasia (FNH) is apparently much less frequently related to OC use and is less likely to bleed seriously than adenoma. Hepatic chemistry is usually normal in adenoma and FNH, but slight increases in serum bilirubin, serum alkaline phosphatase, and serum transaminase may occur. Primary liver cancer (hepatocellular carcinoma or hepatoma) is mostly a disease of males and in the US and Western Europe seldom develops before age 40. Fibrolamellar carcinoma, which characteristically develops in adolescents and young adults, occurs with equal sex incidence. Doubt has been expressed about its relationship to OCs. In the US about 75% of primary hepatocellular carcinomas are associated with cirrhosis, and about 5% of cirrhosis cases develop primary liver cancer. Clinical manifestations of hepatoma have been divided into 5 groups: frank cancer (62.7%), acute abdominal cancer (8%), febrile cancer (8%), occult cancer (16%), and metastatic cancer (5%). Detection of large amounts of alpha fetoprotein has proven useful in diagnosis of hepatocellular carcinoma, but values may be negative in OC users. It has been estimated that 1/3 to 1/2 of all malignant tumors eventually metastasize to the liver.
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PMID:Hepatic neoplasia: selected clinical aspects. 619 95

Mitomycin C microcapsules (MMC-mc), which were developed as a novel drug carrier, have proved to exert a potential therapeutic effect due to both microinfarction and sustained drug action (chemo-embolization), when infused into a tumor supplying arteries. Experimental studies have demonstrated that chemo-embolization with MMC-mc produces a definitely marked and extensive cytotoxicity in target tissues as compared with traditional arterial chemotherapy, embolization or combination of both. Sixty-seven patients with advanced hepatoma were treated with intra-arterial MMC-mc during the period from 1978 to 1982. Since the majority of patients were in far advanced stages, 56 patients received only single or two infusions of an average dose of 20 mg MMC-mc. Objective tumor reduction greater than 25% in area was observed in 22 (40%) of measurable 55 tumors. Elevated serum alpha-fetoprotein in 26 patients improved in 22 (85%). Relative survival rates of 59 patients without distant metastasis were 64% at 3 months, 49% at 6 months and 26% at 12 months. Side effects such as bone marrow depression, decreased liver function, fever, anorexia, pain and infection were experienced in 9 to 39%, but the majority of them were mild and controllable. Our preliminary experience suggests that MMC-mc can be effectively used in treatment of liver tumors as a palliative but also as a preoperative measure. Further clinical trials including controlled study may well demonstrate the advantages of MMC-mc.
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PMID:[Chemo-embolization with mitomycin C microcapsules for hepatoma]. 620 39

The authors report a series of 13 cases of bony metastases leading to the discovery of a hepatoma. They were subjects of male sex, average age 64 years. Nine were severe alcoholics. The presenting symptoms were in 7 cases neurological, in four cases an isolated bone tumour, finally, one spontaneous fracture, and one case with pain alone. Severe loss of weight was frequent; in 10 cases out of 13 it was greater than 5 kg. Hepatomegaly was found in 8 cases, but in 3 cases there was no sign suggesting liver disease. In 7 cases out of nine, the metastases were already numerous at the time of diagnosis. The diagnosis of metastases from a hepatoma was made on the bone histology 11 times and from the hepatic histology in 6 cases. The histological of the bone metastasis reproduces very well that of the liver. In four cases there was local secretion of bile, in one case the metastatic liver cells underwent steatonecrosis.
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PMID:[Bone metastasis revealing a hepatoma. 13 cases]. 626 7

The purpose of this investigation was to ascertain the prevalence and manifestations of tumorous invasion of the lumen of the bile ducts, a mode of local extension characteristic of hepatocellular carcinoma. In a series of 140 necropsied patients with hepatocellular carcinoma, tumorous invasion of the bile duct was noted in three patients (2.1%). Marked cholestasis was present in these three patients; the other manifestations related to the tumorous invasion of the bile duct were biliary pain in one and gall-bladder enlargement in two patients.
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PMID:Invasion of the lumen of the bile ducts by hepatocellular carcinoma. 629 40

The possible association of hepatocellular carcinoma with oral contraceptive (OC) use is supported by the case of a 33-year old black female, gravida 5, para 4. She presented in April 1978 with right upper quadrant pain, nausea, vomiting, and fatty food intolerance. The case had been taking norethindrone, 1 mg with mestranol 0.05, for 2 years. There was no history of liver disease, alcohol abuse, or exposure to chemical toxins. The preoperative diagnosis was subacute cholecystitis; however, an unresectable primary liver tumor of both lobes was detected on surgery. OC use was discontinued, and the case refused chemotherapy. On December 1, 1978, she presented with a 9-week pregnancy which was aborted. Physical examination revealed an enlarged liver and mass in the upper right quadrant. The patient was readmitted December 11 with intractable pain and discharged. She died December 28, 1978. At autopsy the liver tumor appeared as a moderate to poorly differentiated hepatoma with irregular hyperchromatic nuclei. There was no evidence of coexistent benign lesions. The rapid progression of the disease following pregnancy suggests that hepatic growth was stimulated by the high estrogen levels of pregnancy. Earlier diagnosis and improved management are required in such cases. Ultrasonography can be used to confirm the presence of a mass, and liver scan or hepatic angiogram may be useful. Liver biopsy is required for definitive diagnosis. Treatment involves discontinuation of OC use and complete excision of the tumor where possible. If tumors have progressed beyond the stage of resectability, as in this case, the prognosis is poor.
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PMID:Hepatocellular carcinoma associated with oral contraceptive use and pregnancy. 629 72

Based on strict predefined histologic criteria, we identified 23 patients with hepatic adenoma and 41 patients with focal nodular hyperplasia seen at this institution between 1961 and 1980. Patients with hepatic adenoma were young and 91% were female. When a reliable history was available, 89% had used oral contraceptives; 53% presented acutely or with pain. Eleven of 11 radionuclide scans were abnormal; 15 of 15 angiograms showed a hypervascular mass with 7 of 15 showing areas of hypovascularity. Eighteen resections were performed with one operative death. Two tumors contained areas of unequivocal hepatocellular carcinoma. Fifteen of 18 patients followed for 82 +/- 11 mo were living and well and had discontinued oral contraceptives. Focal nodular hyperplasia patients were older, 88% were female, and 58% had used oral contraceptives. Their lesions were discovered accidentally. Seven of 12 radionuclide scans demonstrated voids, while 13 of 13 angiograms showed hypervascular lesions with no areas of hypovascularity. Seventeen tumors were resected. Twenty-three of 24 patients followed for 45 +/- 7 mo were living and well. One died of nonhepatic causes. Based on the findings of this review, we believe that if the clinical suspicion of hepatic adenoma or focal nodular hyperplasia is strong, elective laparotomy for diagnosis is usually the best approach. Hepatic adenoma should be resected if technically feasible. Intraoperative wedge biopsy is appropriate for focal nodular hyperplasia.
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PMID:Hepatic adenoma and focal nodular hyperplasia: clinical, pathologic, and radiologic features. 629 76

We studied 86 cases of hepatocellular carcinoma treated between 1968 and 1982. All other liver tumors were excluded. There were 73 male and 13 female patients (average age, 59 years). The most frequent symptoms were pain (73%), weight loss (56%), and increased abdominal girth (23%). The alpha 1-fetoprotein level was elevated in 23 of 32 patients, and the hepatitis B surface antigen was positive in 15 of 36. Significant differences in the hematocrit reading and total bilirubin and total protein levels were found between those patients with resectable and unresectable tumors. Forty-six patients underwent laparotomy, with a resection rate of 48%. There were six right hepatic lobectomies, four left hepatic lobectomies, and 12 trisegmentectomies . The long-term survival in patients who underwent laparotomy and biopsy only was 4.2 months, while those who underwent resection had an average longevity of 18.7 months (the longest was 11.5 years). Using new imaging techniques, the extent of tumor involvement and operability can be determined with greater accuracy. Criteria for resectability include (1) the absence of vena caval occlusion, (2) the lack of spread between lobes, (3) the absence of portal vein obstruction, and (4) the lack of extrahepatic metastasis.
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PMID:Hepatocellular carcinoma. Changing concepts in diagnosis and management. 632 32

We herein report a case of pedunculated hepatoma which was preoperatively diagnosed as nonfunctioning adrenal tumor. A 51-year-old man was admitted for further examination of right hypochondrial pain. CT scan showed a right suprarenal mass. Tumor vessels were visualized on selective right renal arteriography and right inferior phrenic arteriography. Adrenal function was normal. Preoperative diagnosis was nonfunctioning right adrenal tumor. On operation, we found a right suprarenal tumor which was in continuity with the inferior part of the liver. Pathological diagnosis of the biopsy specimen was hepatocellular carcinoma (Edmondson's grade 3). Difficulty of preoperative diagnosis of pedunculated hepatoma is discussed.
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PMID:[A case of pedunculated hepatoma suspected of adrenal tumor]. 633 Nov 39

In vitro and in vivo animal studies and some clinical trials have shown apparent benefit from thermochemotherapy; however, this treatment modality has not been adequately tested in humans. This investigation evaluated response to and toxicity of secondary thermochemotherapy, using each patient as his own control. Patients with advanced cancer who had documented disease progression while receiving chemotherapy alone were subsequently treated with the same drug, by the same dose and route, combined with localized hyperthermia. Thirty-four patients whose diseases included metastatic colon carcinoma, melanoma, sarcoma and hepatoma in viscera (29) or surface tissues (5) were treated with combination thermochemotherapy for 1 hour daily for 5 days/month. Effective heating from 41 to 45 degrees C minimum tumor temperature was possible in 17/19 (89%) tumors in which temperatures could be measured safely. The authors observed 5 (15%) tumor regressions for 1 to 5 months (median, 2 months), and 19 (56%) tumor stabilizations (growth arrest of previously progressive disease) for 1 to 9 months (median, 4 months). Subjective improvement in activity and/or pain control occurred in 6 (18%) patients and 20 (59%) had no progression of symptoms during treatment. Moreover, there was no detectable morbidity from localized hyperthermia, and no evidence of increased chemotherapy toxicity. While the mechanism(s) of response is poorly understood, the documented disease regressions and stabilizations of previously progressive disease in 24 (71%) patients during secondary combination thermochemotherapy indicates that the addition of hyperthermia may have useful anticancer activity. Expanded trials are warranted.
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PMID:Clinical thermochemotherapy. A controlled trial in advanced cancer patients. 636 31


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