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Query: UMLS:C0345904 (liver cancer)
 15,188 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cholangiocarcinoma constitutes the second most common primary liver cancer after hepatocellular carcinoma. It is particularly prevalent in regions where liver flukes are hyperendemic. Obstructive jaundice is the most common presentation. To evaluate patients suspected for cholangiocarcinoma, endoscopy is becoming more popular. Endoscopy can provide important information especially cholangiogram and tissue diagnosis. Recently, the role of endoscopy has not only been used for diagnosis but also for treatment. In this article, the roles of endoscopy for diagnosis, therapy, and future modality of treatment for cholangiocarcinoma are provided.
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PMID:Endoscopic management of cholangiocarcinoma. 1152 73

We report a patient with combined hepatocellular carcinoma and cholangiocarcinoma (HCC-CC) growing into the common bile duct (CBD) and showing obstructive jaundice within 2 years of the onset of the disease. The patient was a 59-year-old Japanese man in whom, at the age of 57 years. a hepatic tumor was discovered by diagnostic imaging during follow-up of hepatitis B surface antigen (HBsAg)-positive liver cirrhosis. The tumor was diagnosed as HCC. Epirubicin was injected twice, intraarterially. The patient then received oral etoposide therapy for the next 14 months. The treatment was initially effective, but approximately 2 years after the hepatic tumor was discovered, local recurrence of the tumor and a tumor thrombus in the CBD were discovered. Although he was treated with percutaneous transhepatic biliary drainage (PTBD), to reduce obstructive jaundice, the jaundice was irreversible and he died of severe hepatic failure. The autopsy findings confirmed that the hepatic tumor was HCC-CC, in which the HCC and CC components expressed alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9), respectively, which accurately reflected the disease process. The underlying mechanism of the growth of HCC-CC into the CBD may differ from the underlying mechanism of the development of icteric-type HCC.
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PMID:Combined hepatocellular carcinoma and cholangiocarcinoma growing into the common bile duct. 1177 13

Hepatectomy for biliary tract carcinoma with obstructive jaundice is associated with a higher incidence of postoperative septic complications as compared with hepatectomy for hepatocellular carcinoma or metastatic liver cancer. Since most bacteria isolated from septic sites are identical to those found in the preoperative percutaneous transhepatic biliary drainage (PTBD) bile, bacterial colonization in bile appears to be responsible for posthepatectomy septic complications in patients with biliary tract carcinoma. Although it remains unclear how bile becomes contaminated after bile duct obstruction or why preoperative PTBD increases the incidence of biliary infection, bacterial translocation via the portal vein, resulting from loss of integrity of the intestinal mucosa and change in intestinal microflora, may in part account for the mechanisms. Moreover, impaired function of Kupffer cells and altered structure and function of hepatocyte tight junctions might also participate in the development of postoperative bacteremia in such patients. As septic complications and liver failure are profoundly associated with each other, it is important to take all measures before surgery to enhance liver function and to prevent postoperative septic complications.
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PMID:[Biliary bacterial infection in liver surgery]. 1259 25

To study the manifestations of endoscopic retrograde cholangiopancreatography (ERCP) in patients of obstructive jaundice associated with HCC, 32 cases of histopathologically diagnosed HCC with obstructive jaundice were successfully examined with routine ERCP. 31 patients were demonstrated by ERCP as having malignant obstructive jaundice. Among them, 19 were hepatic perihilar bile duct stricture, 7 bile ductile tumorous thrombus, 3 perihilar bile duct stricture complicated with thrombus, 2 metastasis to hilar lymph node, and 1 common bile duct stone as proven by sphincterotomy. The malignant perihilar stricture was all of type III and IV by Bismuth standard of Klastin tumor. In patients identified as having bile duct tumor thrombus, by the Ueda classification, none was of type I and II; 1 type III a; 4 III b; 2 type IV. HCC with obstructive jaundice was mainly caused by the malignant infiltration of tumor, and most stricture was of serious nature. When major extra-hepatic bile duct was involved by tumor thrombus, obstructive jaundice might develop. Malignant perihilar stricture and tumor thrombus might coexist in some patients. Jaundice was rarely caused by hepatic hilar lymph node metastasis. Jaundice was not necessarily caused by tumors and sometimes, it might be caused by common bile stones. Care should be exercised in differentiation diagnosis in such patients.
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PMID:The endoscopic retrograde cholangiopancreatographic manifestations of histopathologically diagnosed hepatocellular carcinoma with obstructive jaundice. 1265 15

Indirect immunoperoxidase assay and computer analysis of photographic images revealed more intensive expression of prolactin receptors in hepatocytes of women compared to men. The intensity of expression was maximum in secondary liver cancer, high in obstructive jaundice of different etiology, and less pronounced in cholelithiasis. The expression of prolactin receptors in cholangiocytes was higher than in hepatocytes and was maximum during obstructive jaundice of different etiology. Cells of secondary tumors were characterized by low expression, while distant hepatocytes most intensively expressed prolactin receptors.
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PMID:Expression of prolactin receptors in human liver during cholestasis of different etiology and secondary liver cancer. 1293 75

We analyzed lipids in liver diseases by agarose gel electrophoresis, and differential staining and simultaneous analysis of the cholesterol (Chol) and triglyceride (TG) fractions. Liver diseases were classified into chronic hepatitis (CH), liver cirrhosis (LC), hepatocellular carcinoma (HCC), and metastatic liver cancer, and each fraction was compared among these diseases. Atypical patterns that were unclassifiable according to the WHO classification of hyperlipidemia phenotypes were classified, and their clinical importance was evaluated. With progression of the pathologic conditions of CH, LC, and HCC, the T-Chol level, each Chol fraction, and the TG fraction decreased while the LDL-TG fraction increased. Metastatic liver cancer showed a lower HDL-fraction level but higher levels of the other parameters than HCC. When the subjects were classified into survivors and patients who died, the HDL fraction level in HCC and metastatic liver cancer, and the LDL level in LC and metastatic liver cancer differed between survivors and patients who died. Phenotypes of hyperlipidemia also differed among diseases, and atypical patterns were frequently observed in patients who died. There were 6 atypical patterns, of which 4 (slow alpha HDL, abnormal LDL, Lp-X, and Lp-Y) were associated with liver diseases. Slow alpha HDL appeared during slight bile stagnation and was accompanied by increases in the apo E level and the HDL particle size. Abnormal LDL appeared with severe liver dysfunction; a TG peak appeared at the position of LDL, and the HDL and VLDL fractions were negligible. Lp-X was a Chol-rich band, occurring on the cathode side of LDL in the presence of marked bile stagnation such as that in obstructive jaundice, and was accompanied by appearance of abnormal LDL. Lp-Y was similar to Lp-X in terms of mobility and associated diseases but contained Chol and TG. Abnormal LDL, Lp-X, and Lp-Y were often observed in patients with poor outcomes. Lipid analysis in liver diseases by this method showed results reflecting the pathologic conditions and may be clinically useful.
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PMID:Clinical significance of abnormal lipoprotein patterns in liver diseases. 1575 28

Alveolar echinococcosis of the liver, caused by the larval stage of Echinococcus multilocularis, has the characteristics of a slow-growing liver cancer. The aim of the present work was to report a series of patients who received orthotopic liver transplantation (OLT) for life-threatening disease. Our article summarizes the medical history, diagnosis, treatment, and prognosis of five patients who received OLT between 2001 and 2002. Most patients had a long history of symptomatic disease (iterative cholangitis, obstructive jaundice) and repeated abdominal surgery. One patient died during the hospitalization mostly related to bacterial infection and multiple organ failure. Another accidental death happened 3 months later from heart failure. Three patients are alive in good condition verifying that OLT is a feasible option for these end-stage cases. In general, combination therapy-chemotherapy, interventional therapy, radical surgery or/and OLT at an early stage-is proposed in advanced cases of which OLT has clearly played a vital role. Despite major technical difficulties, OLT for incurable disease is feasible. Specific management is needed to improve the results: earlier decision for OLT in symptomatic disease, routine pre- and post-transplant therapy, reduced immunosuppression, and regular follow-up.
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PMID:Orthotopic liver transplantation for incurable alveolar echinococcosis: report of five cases from west China. 1596 73

Cholangiocarcinoma is the second most common primary hepatic cancer. Despite advances in diagnostic techniques during the past decade, cholangiocarcinoma is usually encountered at an advanced stage. In this review, we describe the classification, diagnosis, and initial management of cholangiocarcinoma with obstructive jaundice.
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PMID:Diagnosis and initial management of cholangiocarcinoma with obstructive jaundice. 1849 50

A novel microwave electrode with a cooled tip (FORSEA MTC-3 type, China) was devised to better enable microwave ablation of liver cancers. The efficacy of this technology was evaluated. The records of 160 patients (97 with hepatoma, 63 with metastatic cancer of the liver) who had undergone microwave ablation with this new device were reviewed. One-year survival in 86 patients whose follow-up had been more than one year was determined. Pre-operative and post-operative contrast-enhanced CT scans were performed to assess completion of therapy and the presence or absence of recurrent tumor. For patients with hepatoma, serum alpha-fetoprotein (AFP) levels were evaluated pre-operatively and, if elevated, post-operatively. A median two (range one to five) applications were required per session. All patients exhibited initial radiographic resolution of their lesions after therapy. The ablated areas were not enhanced in any phases of contrast CT scan. Eight patients required a second microwave therapy for recurrent tumor; two patients required a third treatment. Twenty-five patients with hepatoma had elevated AFP (104.2+/-22.5 ng/ml), which, after microwave ablation, recovered to normal or almost normal (24.6+/-3.6 ng/ml) (t = 2.1, p<0.05). There were no post-operative deaths. Complications included fever in three of four patients, successfully treated with indomethacin, elevated transaminases in four of five patients, requiring no treatment except for those with pre-operative ascites (who were dialyzed), pleural effusions in fourteen patients, only one of whom required drainage, and obstructive jaundice requiring drainage in two patients. The one-year survival rate was 91.9%. Microwave ablation with this novel cooled-tip electrode is safe, minimally invasive and effective. The tool may greatly expand the fraction of patients with liver cancer who might be candidates for microwave ablation.
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PMID:Microwave ablation with cooled-tip electrode for liver cancer: an analysis of 160 cases. 1992 3

We report the case of a 69-year-old male patient with diagnoses of sigmoid colon cancer, ascending colon cancer, and metastatic liver cancer. We performed sigmoidectomy, right hemicolectomy, and central venous port placement. Because the liver metastasis was multifocal, chemotherapy was first initiated and then hepatic resection was performed. However, during chemotherapy, ileus, with a peritoneal dissemination to the small intestine, developed. Small intestine resection and radiation therapy to the pelvic region of the transition were further performed. Thereafter, obstructive jaundice due to obstruction of the bile duct in the hilar area developed, and therefore, we inserted a biliary stent. However, 2 years 9 months after the first medical examination, this patient died of colon cancer. The guidelines above, still chemotherapy developed, treatment policy of recurrent colorectal cancer, have recommended surgical resection with respect to what resectable as local therapy. This case shows that combination therapy with chemotherapy, surgical therapy, radiation therapy, and local therapy such as biliary stenting, is useful.
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PMID:[Multi-modarity treatment for colon liver metastases using biliary stent-report of a case]. 2439 13


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