Difference between revisions of "Liver neoplasms"

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==Hepatocellular carcinoma==
==Hepatocellular carcinoma==
*Commonly abbreviated ''HCC''.
===General===
===General===
*Commonly abbreviated ''HCC''.
Clinical:
 
====Clinical====
*Serum AFP elevated - in approx. 50% of patients.<ref>{{Ref GLP|588}}</ref>
*Serum AFP elevated - in approx. 50% of patients.<ref>{{Ref GLP|588}}</ref>
*Treatments: RFA (radiofrequency ablation), ethanol ablation, liver resection, liver transplant.<ref name=emed_hcc>[http://emedicine.medscape.com/article/282814-overview http://emedicine.medscape.com/article/282814-overview]</ref>
*Treatments: RFA (radiofrequency ablation), ethanol ablation, liver resection, liver transplant.<ref name=emed_hcc>[http://emedicine.medscape.com/article/282814-overview http://emedicine.medscape.com/article/282814-overview]</ref>
*Mean survival at time of diagnosis ~6 months.<ref name=emed_hcc/>
*Mean survival at time of diagnosis ~6 months.<ref name=emed_hcc/>


====Epidemiology====
Epidemiology:
*Highest where prevalence of hepatitis B virus (HBV) is high.<ref name=Ref_PBoD924>{{Ref PBoD|924}}</ref>
*Highest where prevalence of hepatitis B virus (HBV) is high.<ref name=Ref_PBoD924>{{Ref PBoD|924}}</ref>
*HCC generally arises in the setting of [[cirrhosis]].
*HCC generally arises in the setting of [[cirrhosis]].
**HBV commonly leads to HCC without [[cirrhosis]]<ref name=Ref_PBoD924>{{Ref PBoD|924}}</ref> - may be ''without'' cirrhosis as it is regressed.
**Cirrhosis may be regressed and therefore not appreciated.
 
HCCs '''without''' cirrhosis:
*Hepatitis B virus.<ref name=Ref_PBoD924>{{Ref PBoD|924}}</ref>
*Hemochromatosis.
*Fibrolamellar HCC.


Risk factors:<ref name=Ref_PBoD924>{{Ref PBoD|924}}</ref><ref name=pmid18333156>{{cite journal |author=Leong TY, Leong AS |title=Epidemiology and carcinogenesis of hepatocellular carcinoma |journal=HPB (Oxford) |volume=7 |issue=1 |pages=5–15 |year=2005 |pmid=18333156 |pmc=2023917 |doi=10.1080/13651820410024021 |url=}}</ref>
Risk factors:<ref name=Ref_PBoD924>{{Ref PBoD|924}}</ref><ref name=pmid18333156>{{cite journal |author=Leong TY, Leong AS |title=Epidemiology and carcinogenesis of hepatocellular carcinoma |journal=HPB (Oxford) |volume=7 |issue=1 |pages=5–15 |year=2005 |pmid=18333156 |pmc=2023917 |doi=10.1080/13651820410024021 |url=}}</ref>
*Chronic alcoholism.
*Chronic alcoholism.
*Hepatitis C virus (HCV) - chronic infection.
*[[Hepatitis C]] virus (HCV) - chronic infection.
*HBV - chronic infection.
*[[Hepatitis B]] virus (HBV) - chronic infection.
*Aflatoxins (food contaminant - mould).<ref name=emed_hcc/>
*Aflatoxins (food contaminant - mould).<ref name=emed_hcc/>
*Hereditary tyrosinemia.
*Hereditary tyrosinemia.
*Hereditary hemochromatosis.
*[[Hereditary hemochromatosis]].


===Gross===
===Gross===
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