14 Jul 2011

Hepatocellular carcinoma

Primary liver cell carcinoma; Tumor - liver; Liver cancer; Cancer – liver

Hepatocellular carcinoma is cancer of the liver.
Causes, occurrence, and risk factors
Hepatocellular carcinoma accounts for most liver cancers. This type of cancer occurs more often in men than women. It is usually seen in people ages 50 - 60.
The disease is more common in parts of Africa and Asia than in North or South America and Europe.
Hepatocellular carcinoma is not the same as metastatic liver cancer, which starts in another organ (such as the breast or colon) and spreads to the liver.
In most cases, the cause of liver cancer is usually scarring of the liver (cirrhosis). Cirrhosis may be caused by:
    Alcohol abuse (the most common cause in the United States)
    Certain autoimmune diseases of the liver
    Diseases that cause long-term inflammation of the liver
    Hepatitis B or C virus infection
    Too much iron in the body (hemochromatosis)
Patients with hepatitis B or C are at risk for liver cancer, even if they do not have cirrhosis.
Symptoms
    Abdominal pain or tenderness, especially in the upper-right part
    Easy bruising or bleeding
    Enlarged abdomen
    Yellow skin or eyes (jaundice)
Cipher and tests
Physical examination may show an enlarged, tender liver.
Tests include:
    Abdominal CT scan
    Abdominal ultrasound
    Liver biopsy
    Liver enzymes (liver function tests)
    Liver scan
    Serum alpha fetoprotein
Some high-risk patients may get periodic blood tests and ultrasounds to see whether tumors are developing.
Action - Treatment
Aggressive surgery or a liver transplant can successfully treat small or slow-growing tumors if they are diagnosed early. However, few patients are diagnosed early.
Chemotherapy and radiation treatments are not usually effective. However, they may be used to shrink large tumors so that surgery has a greater chance of success.
Sorafenib tosylate (Nexavar), an oral medicine that blocks tumor growth, is now approved for patients with advanced hepatocellular carcinoma.
References
    National Cancer Institute. Adult primary liver cancer treatment PDQ. Updated May 22, 2009.
    Roberts LR. Liver and biliary tract tumors. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:Chap 206.

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