Hepatocellular carcinoma Flashcards
Define Hepatocellular carcinoma
Primary cancer arising from hepatocytes in the liver-usually cirrhotic liver
Very aggressive tumour
Blood from all over the body-so many secondary cancers, most often adenocarnioma
Aetiology and risk factors of Hepatocellular carcinoma
Multifactorial (like every cancer)
Major risk factor is cirrhosis -chronic Hep B, C, alcohol, NASH–and can add on top of one another
nearly 44% of cases are Hep B related
Chronic inflam drives molecular deregulation leading to dysplasia and cancer
Once dysplastic, becomes cancer in average 5 years
Blood from all over the body-so many secondary cancers, most often adenocarnioma
Risk factors Cirrhosis Hep B/C Alcohol Insulin resistance/NASH/obesity Men (drink more alcohol)
Age-around 60
FHx
Smoking
Primary billiary cholangitis
Epidiemology of Hepatocellular carcinoma
6th most common cancer, and 2nd leading cause of death in WORLD
Its prevalence nearly follows the prevalence of HepB/C
nearly 44% of cases are Hep B related
EU cases 10 in 100 000 (men) and 3(women)
rising in western world tho
Signs and Sx of Hepatocellular carcinoma
As all cancer-not Sx for so long
FLAWS-esp weight loss and appetite loss
cachexia
The typical clinical features of HCC are right upper quadrant abdominal pain, jaundice, abdominal distension, leg oedema, early satiety, and weight loss
Leg oedema from hypoalbuminia
Hepatomegaly
Once symptomatic its fucked tho (0% 5 year survival rate)
Then a lot of signs of cirrhosis ascites Caput medusae Variceal bleed RUQ pain Jaundice Splenomegaly Spider naevi Asterixis Palmar erythema
Metastases-bone pain,
investigation of Hepatocellular carcinoma
FBC-aneamia
Metabolic panel-hyponatremia (Due to water retention)
High LFT (not ALP(), low albumin
Viral hep panel-can be raised
alpha fetoprotein-HCC marker
CT of abdo
Biopsy-diagnose-CELLS THAT mAKE BILE if not secondary
bone scan-Cmetastases
