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Difference between revisions of "Liver neoplasms"
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==Hepatocellular carcinoma== | ==Hepatocellular carcinoma== | ||
*Commonly abbreviated ''HCC''. | |||
===General=== | ===General=== | ||
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: | |||
*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]]. | ||
** | **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=== | ||