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

Combined hepatocellular-cholangiocarcinoma is a rare form of primary liver cancer showing features of both hepatocellular and biliary epithelial differentiation. In a review of 24 cases of this tumor, three histologic types were encountered. Four cases were Type I or "collision tumors," apparently a coincidental occurrence of both hepatocellular carcinoma and cholangiocarcinoma in the same patient. Twelve cases were Type II or "transitional tumors," in which there were areas of intermediate differentiation and an identifiable transition between hepatocellular carcinoma and cholangiocarcinoma. Eight cases were Type III or "fibrolamellar tumors" which resembled the fibrolamellar variant of hepatocellular carcinoma but which also contained mucin-producing pseudoglands. Type III tumors differ from other combined tumors, occurring at a younger age, in the absence of cirrhosis, and having a slightly longer survival. Immunohistochemical (immunoperoxidase) staining for intracellular antigens showed that alpha-fetoprotein is a fairly specific, although insensitive, marker of hepatocellular differentiation in primary liver cancers, being present in 50% of typical hepatocellular carcinomas and in hepatocellular areas in 29% of combined tumors, but in no cholangiocarcinomas or cholangiocellular areas of combined tumors. Keratin is a good marker of biliary epithelial differentiation, being found in 90% of cholangiocarcinomas and in 52% of combined hepatocellular cholangiocarcinomas, but in no hepatocellular carcinomas. Alpha-1-antitrypsin, fibrinogen, IgG, and carcinoembryonic antigen may be found in both hepatocellular carcinoma, cholangiocarcinoma, and in combined tumors; these antigens are therefore of limited use in differential diagnosis.
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PMID:Combined hepatocellular-cholangiocarcinoma. A histologic and immunohistochemical study. 257 78

Since the first report of inflammatory pseudotumor of the liver in 1953, 12 cases have been reported in the literature. The authors report herein five cases of inflammatory pseudotumor of the liver in our hospital. These tumors were resected and the diagnosis confirmed pathologically. Three of the patients were male and two female. Four of these patients had been misdiagnosed as having primary liver cancer by sonography and CT scan. Our experience has shown that if the patient had a long clinical course, few clinical symptoms, good general condition, and a negative alpha-fetoprotein assay, if the tumor was well encapsulated and the liver presented without cirrhosis, the patients should be suspected of having inflammatory pseudotumor of liver. In this series, all five patients underwent hepatectomy. There were no complications after operation. Surgical resection should be considered as the main therapeutic method for inflammatory pseudotumor of liver. If the patient proves unsuitable for surgical treatment, steroid therapy should be the treatment of choice. In this paper 12 cases of inflammatory pseudotumor of liver reported in the literature are reviewed and discussed.
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PMID:Inflammatory pseudotumor of the liver. 268 84

Thirty-two patients with a solitary hepatocellular carcinoma of less than 4 cm diameter were treated during the 13 years from 1971 to 1983, two-thirds of them since 1981. Serum alpha-fetoprotein levels proved to be an excellent diagnostic tool for these early stage carcinomas which are generally asymptomatic. Ultrasonography forms an invaluable test for the detection of occult liver cancer and has enhanced the ability to detect small sized lesions. The accuracy of this method increased from 25 per cent for the period 1971-1980 to 89 per cent for the period 1981-1983. The cumulative survival rates for the 32 patients treated by hepatic resection at 1, 2 and 5 years were 85, 70 and 22.2 per cent (excluded from these figures are four operative deaths giving a 12.5 per cent operative mortality).
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PMID:The value of ultrasound in the diagnosis and treatment of small hepatocellular carcinoma. 298 96

Liver cancer is the most common of all malignancies worldwide, its incidence reaching almost epidemic proportions in some countries. However, its significance in North America has generally been underemphasized. In a 5 year period, hepatocellular carcinoma was diagnosed in 35 adult patients in our institution. Preexisting liver inflammation was present in 27 of the patients (77 percent). Although most patients had symptoms, they included only poorly defined pain or cachexia in most cases, and 10 patients (29 percent) were totally asymptomatic at the time of diagnosis. Five patients presented with hemoperitoneum due to intraabdominal tumor rupture. Examinations useful in confirming the diagnosis included alpha-fetoprotein determination, liver scan, and computerized tomographic scanning. Eight patients (23 percent) had associated visceral or other malignancies. The outlook was poor, with a mean survival of 5 months, and only two patients survived more than 1 year. Hepatocellular carcinoma is uncommon but not at all rare in the Pacific Northwest. It arises from chronic liver inflammation, is diagnosed late, and has a grim prognosis. Prevention of various forms of chronic liver inflammation, and mass serial screening of populations at high risk for the development of hepatocellular malignancy will probably have the greatest role in reducing the lethality of this disease.
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PMID:Hepatocellular carcinoma. A 5 year institutional experience. 298 72

Seven cases of hepatocellular carcinoma (hepatoma) (HCC) presenting as primary extrahepatic masses on CT are reported. All cases were diagnosed at the time of percutaneous biopsy, surgical resection, or autopsy. In none of the cases was the final diagnosis of HCC prospectively suspected on the basis of clinical and radiologic findings. Although three of the patients were at higher risk for development of HCC because of their medical histories, the absence of an elevated serum alpha-fetoprotein level and the extrahepatic location of the masses by CT suggested other disease. This variable pattern of radiologic presentation of HCC should be kept in mind during the evaluation of patients with suspected HCC, or when the findings on abdominal/pelvic CT of mass and presumed hepatic metastases are at variance with the clinical presentation.
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PMID:Hepatocellular carcinoma presenting as primary extrahepatic mass on CT. 300 40

The regenerative process was evaluated in terms of liver size, function, and histology in 28 adults who had major hepatic resection: hepatocellular carcinoma (HCC) in 21, secondary liver cancer from colorectum in four, carcinoma of the gallbladder in one, Klatskin tumor in one, and Caroli's disease in one. There were 22 men and six women. Ages ranged from 17 to 74 years with a mean age of 56.7. All patients with HCC had underlying liver disease: liver cirrhosis in 14 and chronic hepatitis in seven. Extended right lobectomy was done on 10 patients, right lobectomy on 16 patients, and left lobectomy on two patients. The residual liver size was serially estimated with computed tomography (CT) in 15 patients: six with normal liver, five with chronic hepatitis, and four with cirrhosis. A complete restoration of the residual liver size was found within 3 months in 3 and 6 months, respectively, in two patients with normal livers. The liver was enlarged in all patients with the parenchymal diseases but obviously more slowly compared with normal liver. Liver functions were restored normally within 2-3 weeks in patients with normal livers, but hyperbilirubinemia persisted longer in those with chronic hepatitis and cirrhosis. A continuous rise of bilirubin was an ominous sign of liver failure and subsequent death, which occurred in five patients with cirrhosis. Serum alpha-fetoprotein did not rise in accordance with the regeneration. Histologically, evidence of active regeneration with increased mitotic activity was found at 10 and 35 days in those patients with normal livers. Mitosis was not seen in a specimen taken at 7 days. Enlarged cuboidal hepatocytes and cells with basophilic cytoplasm or two nuclei were observed more or less in all specimens. The livers with cirrhosis or hepatitis also showed histologic evidence of regeneration during the first 2 months but substantially less compared with normal liver, which was well supported by the volumetric study of the liver remnants with CT.
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PMID:Human liver regeneration after major hepatic resection. A study of normal liver and livers with chronic hepatitis and cirrhosis. 303 39

Castrated or sham-operated male athymic mice were inoculated with cells from the human hepatocellular carcinoma cell line PLC/PRF/5. There were no significant differences between the two groups with respect to the number of animals developing tumors, the time to tumor development, or the subsequent rate of increase in either tumor base area or mouse serum alpha-fetoprotein concentration. Androgen receptors were assayed in nuclei obtained from three separate liver cancer cell lines and from normal adult human liver. Similar concentrations, ranging from 235 to 550 fmol/mg DNA, of nuclear androgen receptors were detected in all tissues. Low percentages of androgen receptors were retained on DNA-cellulose. Although the presence of receptors implies the potential for metabolic effects of androgens in normal and malignant liver, our in vivo studies suggest that castration does not alter significantly the growth of liver cancer xenografts in athymic mice.
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PMID:Human hepatocellular carcinoma tumor xenografts. Their androgen-receptor status and growth responses to castration. 334 94

Complexes between hepatitis B surface antigen (HBsAg) and immunoglobulin M (IgM) have been detected in acute type B hepatitis. Sequential serum testing for the presence of these complexes has been shown to be the best method for predicting disease chronicity. The presence of HBsAg/IgM complexes was investigated using an enzyme-linked immunosorbent assay with selected sera from Senegal. The three population groups studied were composed of 405 Senegalese soldiers as well as 84 liver cirrhosis and 169 primary liver cancer patients. Only one of the 122 HBsAg negative sera tested was found to be positive for HBsAg/IgM complexes. Complexes were detected 13.9% of the HBsAg positive soldiers, in 40% of the HBsAg positive liver cirrhosis patients, and in 50% of the HBsAg positive primary liver cancer patients. HBsAg/IgM complexes were also detected in 53.6% of the hepatitis B e antigen (HBe) positive soldiers, compared to 75 and 76% for the HBeAg positive liver cirrhosis and primary liver cancer patients, respectively. In anti-HBe positive sera, an increased proportion of HBsAg/IgM complexes was observed during the sequence chronic hepatitis (5%)-cirrhosis (29%)-primary liver cancer (42%). On the other hand, it has been reported that in the sequence of events leading from chronic hepatitis to primary liver cancer, there is an increase in anti-HBeAg prevalence and in alpha-fetoprotein levels. In this study, only alpha-fetoprotein levels were found to increase. Values higher than 15 IU/ml were observed in 4.3, 27.3, and 86.4% of the HBsAg positive individuals from the three groups. No significant variation was observed in the anti-HBe prevalence between the population group (64-75%).
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PMID:Persistence of circulating complexes between HBsAg and immunoglobulin M in sera of hepatitis B surface antigen positive patients suffering from liver cirrhosis or primary liver cancer. 394 6

The early appearance of serum alpha-fetoprotein (AFP) during hepatocarcinogenesis as a function of age of rats and extent of treatment with 3'-methyl-4-dimethylaminoazobenzene is reported. Administration of .06% of the benzene hepatocarcinogen in the diet of 6- to 12-week-old male rats led to the prompt appearance of AFP in the serum within 3-4 weeks. Discontinuation of treatment at Week 5 dropped the AFP in serum to undetectable levels within 2 weeks, and it remained negative over a 30-week period when, at autopsy, no liver cancer was found. Administration of azo dye to 6-week-old rats for 10 weeks also decreased AFP in serum to undetectable levels over the next 2 weeks, except in 2 of 45 rats who developed large hepatomas early and remained positive. In the remainder, AFP reappeared beginning at Week 15, and liver cancer was present at Week 20 except for 13 rats that remained negative, although 7 had hepatoma. The age of the rats played no marked role in the precocious appearance of AFP. The presence of AFP in each group was related to the histological picture of the liver at the time of autopsy. There was no detectable AFP in untreated control rats, nor was there any in rats fed .05% of the hepatotoxic but not carcinogenic alpha-naphthylisothiocyanate which led to extensive jaundice and bile duct proliferation.
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PMID:Early appearance of serum -fetoprotein during hepatocarcinogenesis as a function of age of rats and extent of treatment with 3'-methyl-4-dimethylaminoazobenzene. 411 15

Raised serum alpha-fetoprotein levels measured by radioimmunoassay were found in 19 out of 24 (79%) patients with primary liver cancer and in 32 out of 311 (10%) patients with other liver diseases. The rise was transient in cases of hepatitis and a transient rise was also seen after alcohol intake ceased in two patients with cirrhosis. alpha-Fetoprotein levels exceeding 500 ng/ml were 30-50 times more common in primary liver cancer than in other liver diseases. A rise in level seems to reflect the extent of liver regeneration in liver diseases other than primary cancer.
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PMID:Serum alpha-fetoprotein: diagnostic significance in liver disease. 440 83


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