See the lesion at the arrow.
Hepatocellular carcinoma (HCC) is a primary malignancy of the liver. Hepatocellular carcinoma is now the third leading cause of cancer deaths worldwide, with over 500,000 people affected. The incidence of hepatocellular carcinoma is highest in Asia and Africa, where the endemic high prevalence of hepatitis B and hepatitis C strongly predisposes to the development of chronic liver disease and subsequent development of hepatocellular carcinoma.
Hepatocellular carcinoma is a primary cancer of the liver and occurs predominantly in patients with underlying chronic liver disease and cirrhosis.
The cell of origin is believed to be the hepatic stem cells.
Tumors progress with local expansion, intrahepatic spread, and distant metastases.
In general, the tumors are discovered either during routine screening or when symptomatic because of their size or location. Tumors may present as a single mass lesion or as diffuse growth, which can be difficult to differentiate from the surrounding cirrhotic liver tissue and the regenerating liver nodules on imaging studies.
The presentation may be caused in part by mass effect that can lead to obstruction of the biliary system or anywhere affecting the liver vasculature.
Without aggressive surgical resection, ablative therapy, or liver transplantation, hepatocellular carcinoma results in liver failure and death.
In the United States, the risk factors have historically included alcoholic cirrhosis, hepatitis B (HBV) infection, hemochromatosis, and now hepatitis C (HCV) infection. However, the obesity epidemic has resulted in a growing population of patients with nonalcoholic fatty liver disease, also referred to as nonalcoholic steatohepatitis. Patients with nonalcoholic fatty liver disease can progress to fibrosis, cirrhosis, and now hepatocellular carcinoma.
Among patients with cirrhosis, current recommendations include cross-sectional imaging studies every 6-12 months and serum alpha-fetoprotein (AFP) measurements.
Liver transplant is still the best treatment!!