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

The control of communicable diseases, malnutrition and birth complications has been the main preoccupation of the Member States of the African Region of WHO. As a result of these control measures, death rates, particularly among infants and young children, have continued to decline. This has increased life expectancy to the extent that we are now witnessing the emergence of the diseases prevalent in the industrial world: they have already become a major public health problem in Africa. Carcinoma of the cervix and hepatocellular carcinoma are the commonest forms of cancer afflicting the people of this Region. Others include cancers of the breast, skin, prostate, oesophagus, stomach and bladder. Burkitt's lymphoma is the commonest childhood malignancy. The causal factors of some of these tumours are known, and can therefore be eliminated by primary prevention. This is shown by the almost total absence of carcinoma of the penis in those communities that practise male circumcision, and the decrease in the incidence of squamous-cell carcinoma of the skin that resulted from the prevention of tropical ulcer, thanks to effective care of injuries and wounds. The priorities of the WHO cancer programme are therefore primary prevention, early detection and the provision of adequate pain relief. The success of the programme will depend mainly on whether the services provided will benefit the majority of the population.
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PMID:WHO cancer control programme in the African region. 653 17

Since the initial report in 1973 of 7 women who developed liver tumors while using oral contraceptives (OCs) over 300 cases have been reported. Hapatic tumors associated with OCs are benign (focal nodular hyperplasia or hepatocellular adenoma) or malignant (hepatocellular carcinoma, angiosarcoma, or cholangiocellular carcinoma). Mestranol is the main estrogen related to the development of hepatic adenoma but other OCs containing combinations of ethinyl estradiol, ethyl estradiol, mestranol, norethynodrel, norethisterone, and norgestrol are also associated with the tumors. Longterm OC users have an estimated annual incidence of 3-4/100,000. Hepatic tumors may present with abdominal pain or be an incidental finding on physical examination or at laparotomy. Diagnosis is confirmed by scintigraphy, echography, CT-scanning, angiography, or laparoscopy. Dynamic isotopic scanning may help differentiate between benign and malignant lesions. Symptomatic benign tumors and malignant tumors are best treated by partial hepatectomy and a ban on estrogens. The use of OCs should be forbidden following resections. Surgery is indicated for patients with persistent or recurrent pain, those with intraperitoneal hemorrhage and those in whom a carcinoma is suspected. The administration of synthetic estrogens to experimental animals results in a variety of morphological and functional changes within the hepatocyte. Other possibilities are that the estrogen potentiates the carcinogenicity of other compounds, either by changing their metabolism or by interfering with their excretion due to the cholestatic effects of synthetic estrogens.
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PMID:Oral contraceptives and hepatic tumors. 708 79

Four patients had resection for primary hepatic sarcoma: one with malignant fibrous histiocytoma (MFH), two with poorly differentiated fibrosarcoma, and one with leiomyosarcoma. Age ranged from 40 to 69 years. One patient had a cousin and a grandmother who had died of hepatic tumors. At presentation, all patients had pain; one had tumor rupture, and one had mental changes and hypoglycemia. None had hepatitis or cirrhosis. Results of laboratory evaluation were nonspecific, including normal carcinoembryonic antigen and alpha-fetoprotein levels. Computed tomography showed hypodense masses with enhancement. Angiography showed a hypervascular mass in three patients and an avascular mass in the patient with MFH. Despite large tumors (8 to 32 cm), portal and hepatic veins were not invaded. The pattern of vascularization and lack of venous invasion helps differentiate primary hepatic sarcomas from hepatocellular carcinoma, especially in noncirrhotic patients. All patients had extensive hepatic resections, with one operative death. Immunohistochemical stains of the tumors were positive for vimentin but negative for epithelial markers, differentiating these lesions from other hepatic tumors. The patient with MFH died with recurrence at 10 1/2 months. The patient with the ruptured fibrosarcoma had a second resection and chemotherapy, but died with recurrence at 3 years. The patient with the leiomyosarcoma had a second resection and was disease free at 4 years. Resection of primary hepatic sarcoma is warranted, with potential survival measured in years.
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PMID:Resection of primary hepatic malignant fibrous histiocytoma, fibrosarcoma, and leiomyosarcoma. 751 Sep 7

A 78-year-old female presented with swelling and severe pain in the left forehead secondary to a simple head injury received 1 month previously. On admission, neurological examination was normal. Plain skull x-ray films and computed tomography showed an osteolytic and well-defined mass in the left frontal bone. Bone scintigraphy showed high-uptake areas in the right lower ribs and fifth lumbar vertebra. Blood tests showed slight liver dysfunction and a high alpha-fetoprotein level. Abdominal computed tomography showed a huge mass within the liver. Left common carotid angiography disclosed the enlargement of several feeding arteries arising from the external carotid artery with tumor staining. The bone tumor was removed for histological diagnosis and to reduce the localized pain. The histological diagnosis was a cranial metastasis from hepatocellular carcinoma. She died of ruptured varicose veins of the esophagus approximately 8 months after surgery. Surgery for cranial metastasis from hepatic cancer is only indicated when localized pain or hemorrhage threaten the quality of life.
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PMID:Cranial metastasis of hepatocellular carcinoma in a female--case report. 751 32

Hepatocellular carcinoma is a tumor with high mortality. Adequate oncological therapy is essential to modify the poor prognosis. Transcatheter arterial chemoembolisation has been proposed as a useful and well-tolerated treatment for unresectable carcinoma. In the study 51 patients with unresectable carcinoma (mean age 61.6, range 45-81, Child-Pugh A = 34 patients, Child-B = 13, Child-C = 4; Okuda I = 33 patients, Okuda II = 18) underwent chemoembolisation. A total of 122 procedure were performed, with a median number of 2.4 (range 1-6) per patient. One and two year survivals are 91% and 74% respectively (Child-A: 100% and 82%; Child-B: 100% and 63%; Child-C 0% at 1 year). The difference among the 3 groups is statistically significant (p = 0.001). Median overall survival is 20 months, with 22, 20 and 6 month in Child-A, B and C patients respectively (p = 0.006). Commonly reported side effects and biochemical changes included: fever, pain and increased serum amylase, transaminase levels. One patient developed a liver abscess and died of liver failure. In addition, in 18 patients (35%) mild to severe changes in glucose metabolism were also observed. Mild hyperglycemia was observed in 14 patients, with severe derangement in 4 patients (8%). It is suggested that careful evaluation of glucose metabolism is advisable in patients being considered for chemoembolisation. Their results confirm the usefulness of chemoembolisation in Child-A and B patients with unresectable hepatocellular carcinoma.
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PMID:[Local transcatheter arterial chemoembolization in the palliative treatment of inoperable hepatocellular carcinoma]. 753 8

A case of hepatocellular carcinoma metastatic to the mandible is described. The patient reported swelling, pain, and trismus after a pathologic fracture. After a systematic examination with the use of 99mTc-methylene diphosphonate, 67Ga-citrate, and 99mTc-pyridoxyl-5-methyl triptophan scintigraphy the primary focus was discovered in the right lobe of the liver. The focus was confirmed by computed tomography and magnetic resonance imaging. The histopathologic diagnosis of hepatocellular carcinoma was made from a biopsy specimen of the mandibular lesion.
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PMID:Hepatocellular carcinoma metastatic to the mandible. 760 Feb 32

The antitumor activity of combination therapy with traditional Chinese medicines and OK432 (Streptococcus pyogenes) for cancer patients was investigated. Excellent antitumor activity of this treatment was achieved in one patient with hepatocellular carcinoma. The present report describes the clinical course of this patient and examines the contribution of production of tumor necrosis factor (TNF) and interferon-gamma (IFN). Endogenous production of TNF could be observed after drip intravenous injection of OK 432 in the serum of patients treated by previous oral administration of traditional Chinese medicines. The serum levels of IFN were very low and remained at almost undetectable levels under these conditions. The selective use of immunostimulants such as traditional Chinese medicines may be of value in combination with other therapies such as drip infusion of OK 432, in the treatment of advanced cancer or of aged patients because of the low toxicity. One patient out of 12 revealed a partial response as assessed by the antitumor activity. However, with this treatment, patients did become free from pain and a good performance status was supported.
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PMID:Combination therapy with traditional Chinese medicines and Streptococcus pyogenes products (OK 432) for endogenous tumor necrosis factor therapy. A preliminary report. 766 72

Hepatocellular carcinomas may rupture in rare cases (5 to 15%) creating a serious short-term and mid-term situation. Over a period of 10 years, 20 patients (19 males, 1 female, mean age 68 years, range 38-82) were treated for ruptured hepatocellular carcinoma involving a cirrhotic (ethylic) liver in 12 cases, haemochromatosis in 2 and a normal liver in 6. Twelve patients underwent emergency surgery for acute haemoperitonium operation was delayed until after exploratory investigations (CT scan and arteriography +/- embolization) for pain in the right hypochondria associated with partitioned effusion and anaemia. The diagnosis of cancer had been known in 5 patients and rupture was the first manifestation in 15 others. Emergency procedures, 7 excisions, 3 sutures, were performed but 2 patients died during vascular clamping. Four deaths occurred within 8 days due to liver failure. There were no postoperative deaths after programmed procedures, 6 excisions, 1 ligature. One patient underwent embolization peroperatively and died 6 days later due to digestive haemorrhage and liver failure. Lesions were localized in the left liver (9), right liver (6) and in both with multiple nodules (5). Among the 13 survivors, 7 died within a delay of 2 to 30 months, 1 due to recurrent rupture (5%). Six patients are still living with a follow-up of 3 to 36 months (including 2 hepatocellular carcinomas on a healthy liver and 1 with haemochromatosis). A review of the literature confirms the severity of such events whatever the initial management. Acute rupture of hepatocellular carcinoma usually requires emergency procedures with a high risk of mortality (50%). Fissuration authorizes explorations and possibly peroperative embolization with better immediate results.
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PMID:[Ruptured hepatocarcinoma. Report of 20 cases and review of the literature]. 776 30

Twelve patients with cavernous hemangiomas of the liver were treated by surgical resection from 1982 to 1991. There were three male and nine female patients. Their ages ranged from 31 to 62 with a mean of 49. All except one with gall bladder polyp had abdominal pain. Preoperatively, dynamic computerized tomographic scans performed on three patients produced accurate diagnoses, while angiography was correct in only 2 out of 7 patients. The indications for operation were suspected hepatoma in five, symptomatic pain in three, intraperitoneal hemorrhage resulting from biopsy in one, intrahepatic stone with suspicion of cholangioma in one, abdominal mass mimicking a gastric leiomyosarcoma in one and incidental laparotomy in a final patient. Surgical treatment resulted in no operative mortalities apart from one delayed death from cirrhotic decompensation occurring four months postoperatively. Morbidity included one patient with a postoperative hemorrhage and one with bile leakage, however, both of them were discharged uneventfully. During the follow up period from 6 to 72 months, no more abdominal pain attacked in those three patients with preoperative symptomatic pain. Three patients developed multiple recurrent hemangiomas. No identifiable causes were readily apparent. We conclude that the preoperative differentiation between hemangioma and hepatoma in a hepatic lesion is very important. When necessary, such as a giant symptomatic hemangioma of the liver can be safely resected without significant complications.
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PMID:Resectional therapy for a giant cavernous hemangioma of the liver. 785 Jun 47

A 36-year-old woman was scheduled for Cesarean section under spinal anesthesia. She was a carrier of hepatitis-B-virus and diabetic. She was complaining of low back pain. Spinal anesthesia was performed in the left lateral decubitus position. Because lumbar puncture in the midline was difficult, left paramedian approach was tried. Then she began to complain of right leg pain. Another attempt was made at other site, but her pain was not relieved. After confirming drop of blood-tinged cerebrospinal fluid, 0.3% dibucaine 2.0 ml was injected. Sensory anesthesia was assessed by pin-prick, but anesthesia was not effective. Then epidural catheter was inserted at Th12-L1 using median approach. She received 1.0% lidocaine 15 ml. However, sensory anesthesia was insufficient (Th4-Th12). Therefore O2-N2O was administered in addition to regional anesthesia. After the delivery, she still complained of low back pain. Later examination revealed metastatic bone tumor of L2 from hepatoma. This case suggests that in a patient with such incomplete spinal or epidural anesthesia and neurological finding, vertebral metastatic tumor should be ruled out.
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PMID:[A case of vertebral metastasis revealed by incomplete spinal analgesia for cesarean section]. 793 77


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