Hepatocellular carcinoma overview
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Differentiating Hepatocellular carcinoma from other Diseases |
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Diagnosis |
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Hepatocellular carcinoma overview On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2]
Overview
Hepatocellular carcinoma (HCC, also called hepatoma) is a primary malignancy (cancer) of the liver. The majority of hepaticellular carcinoma cases are due to either a viral hepatitide infection (hepatitis B or C) or cirrhosis (alcoholism being the most common cause of hepatic cirrhosis).[1] In countries where hepatitis is not endemic, most malignant cancers in the liver are not primary hepatocellular carcinoma and the majority of cases aremetastasis from other part of the body, e.g. the colon. Treatment options of hepatocellular carcinoma and prognosis are dependent on many factors, especially on tumor size and staging.
In non western countries, the usual outcome is poor, because only 10 - 20% of hepatocellular carcinomas can be removed completely using surgery. If the cancer cannot be completely removed, the disease is usually deadly within 3 to 6 months [3]. This is partially due to late presentation with large tumours, but also due to the lack of medical expertise and facilities. This is a rare tumor in the United States.
Historical Perspective
Hepatocellular carcinoma was first noted to be associated with hepatitis B infection in 1970.[2]
Pathophysiology
On microscopic histopathological analysis, large polygonal tumours cells with graunular eosinophilic cytoplasm or layered dense collagen bundles are characteristic findings of hepatocellular carcinoma.
Causes
Common causes of hepatocellular carcinoma include hepatitis B, hepatitis C, alcoholic liver cirrhosis, hemochromatosis, and hepatic prophyrias.
Differentiating Hepatocellular Carcinoma from other Diseases
Hepatocellular carcinoma must be differentiated from other diseases that cause abdominal pain, jaundice, and weight loss, such as hepatitis B, hepatitis C, liver cirrhosis, and pancreatitis.
Epidemiology and Demographics
Hepatocellular carcinoma is the 5th most common tumor worldwide. The epidemiology of hepatocellular carcinoma exhibits two main patterns, one in North America and Western Europe and another in non-Western countries, such as those in Sub-Saharan Africa, Central Asia and Southeast Asia, and the Amazon basin. Men are more affected than women and it is more common between the 3rd and 5th decades of life. Hepatocellular carcinoma causes 662,000 deaths worldwide per year.[3]
Risk Factors
Common risk factors in the development of hepatocellular carcinomaare are chronic hepatitis B, chronic hepatitis C, cirrhosis, and inherited metabolic diseases.
Screening
According to the American Association of Liver Diseases recommendations, screening for hepatocellular carcinoma by ultrasound (US) is recommended among patients with hepatitis B, hepatitis C, and cirrhosis. Screening is also recommended for Asian men over the age of 40, Asian women over the age of 50, and African American.
References
- ↑ Kumar V, Fausto N, Abbas A (editors) (2003). Robbins & Cotran Pathologic Basis of Disease (7th ed.). Saunders. pp. pp. 914&ndash, 7. ISBN 978-0-721-60187-8.
- ↑ Di Bisceglie AM (2009). "Hepatitis B and hepatocellular carcinoma". Hepatology. 49 (5 Suppl): S56–60. doi:10.1002/hep.22962. PMC 3047495. PMID 19399807.
- ↑ "Cancer". World Health Organization. February 2006. Retrieved 2007-05-24.