Presentation
The patient is presenting with a fairly large mass in the liver. We are not told what its imaging characteristics are. [targetedonc.com]
Five out of 12 patients who were refractory to MMC or 5-FU by intravenous infusion responded to the present combination drug therapy. [ncbi.nlm.nih.gov]
The study, presented at the ESMO 17th World Congress on Gastrointestinal Cancer, 1-4 July, Barcelona, Spain, represents the first report of a chemoablative effect for PV-10 outside melanoma. [ecancer.org]
Among the six domains of AGREE II, 40 guidelines were scored 60% with a mean of 79% to 83% for two domains, namely scope and purpose, and clarity of presentation. [journals.plos.org]
However, an isolated sternal metastasis from HCC as an initial presentation has been rarely reported. A 45-year-old man presented with a progressively increasing mass over the anterior chest wall. [jcmtjournal.com]
Entire Body System
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Weight Loss
Liver metastases are suspected in patients with weight loss and hepatomegaly or with primary tumors likely to spread to the liver. [msdmanuals.com]
Common side effects include diarrhea, fatigue, nausea and vomiting, poor appetite and weight loss, high blood pressure, hand-foot syndrome (redness and irritation of the hands and feet), and constipation. [cancer.org]
However, as the disease progresses, symptoms associated with liver disease often develop, including: Pain in the upper abdomen on the right side; the pain may extend to the back and shoulder Swollen abdomen (bloating) Weight loss, loss of appetite and [hoag.org]
They can include: Blockage of the flow of bile Decreased appetite Fever Liver failure (usually only in the late stages of disease) Pain Weight loss [surgery.ucsf.edu]
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Fever
[…] abdomen on the right side; the pain may extend to the back and shoulder Swollen abdomen (bloating) Weight loss, loss of appetite and/or feelings of fullness Weakness and/or fatigue Nausea and vomiting Yellow skin and eyes, and dark urine from jaundice Fever [hoag.org]
They can include: Blockage of the flow of bile Decreased appetite Fever Liver failure (usually only in the late stages of disease) Pain Weight loss [surgery.ucsf.edu]
Side effects can include: fatigue, fever, rash, decreased appetite, pain, and an autoimmune reaction involving the lungs, liver, intestine, kidneys, and other organs. Cryoablation and radiofrequency ablation. [webmd.com]
Abdominal pain Pain occurring near the right shoulder blade or in the upper abdomen Loss of appetite, weight loss or nausea Abdominal swelling or bloating in the abdomen Yellowing of the skin and eyes (jaundice) Ongoing fatigue or weakness Unexplained fever [cancercenter.com]
Nonspecific symptoms of cancer (eg, weight loss, anorexia, fever) often develop first. The liver may be enlarged, hard, or tender; massive hepatomegaly with easily palpable nodules signifies advanced disease. [msdmanuals.com]
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Amyloidosis
Metabolic diseases Metabolic diseases based on the liver including: Primary oxaluria Familial amyloidosis 1-antitrypsin deficiency Wilson’s disease Urea cycle enzyme deficiencies Tyrosemia Familial hypercholesterolaemia Criggler Najar syndrome urea cycle [news-medical.net]
High blood pressure Hypercalcemia (high level of calcium in the blood) Polycythemia ("high blood" due to an abnormally high number of red blood cells) Liver disorders Muscle weakness Neuropathy (numbness, tingling, or burning pain in one or more areas) Amyloidosis [emedicinehealth.com]
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Noncompliance
In particular, this noncompliance might threaten the performance and reliability of the instrument [8]. [journals.plos.org]
Gastrointestinal
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Loss of Appetite
The most common side effects of this drug include fatigue, rash, loss of appetite, diarrhea, high blood pressure, and redness, pain, swelling, or blisters on the palms of the hands or soles of the feet. [cancer.org]
Loss of appetite Loss of appetite, or anorexia, is a common symptom of liver metastases. It can be caused by the cancer, the liver not working properly, treatments or other symptoms such as pain and ascites. [cancer.ca]
However, as the disease progresses, symptoms associated with liver disease often develop, including: Pain in the upper abdomen on the right side; the pain may extend to the back and shoulder Swollen abdomen (bloating) Weight loss, loss of appetite and [hoag.org]
Common symptoms of metastatic liver cancer include: Abdominal pain Pain occurring near the right shoulder blade or in the upper abdomen Loss of appetite, weight loss or nausea Abdominal swelling or bloating in the abdomen Yellowing of the skin and eyes [cancercenter.com]
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Abdominal Pain
In the late stages of liver cancer, the tumor invades a number of tissues throughout the abdomen, leading to massive organ damage and abdominal pain. [livestrong.com]
Call your provider if you develop ongoing abdominal pain, especially if you have a history of liver disease. Preventive measures include: Preventing and treating viral hepatitis may help reduce your risk. [medlineplus.gov]
When to see a doctor See your doctor if you have persistent fatigue, abdominal pain, jaundice, or other signs and symptoms that bother you. [mayoclinic.org]
Common symptoms of metastatic liver cancer include: Abdominal pain Pain occurring near the right shoulder blade or in the upper abdomen Loss of appetite, weight loss or nausea Abdominal swelling or bloating in the abdomen Yellowing of the skin and eyes [cancercenter.com]
Call your doctor right away if you develop yellowing of the skin or white part of your eyes (jaundice), dark "tea-colored" urine, light-colored bowel movements (stools), worsening nausea, worsening vomiting, abdominal pain. birth defects or death of an [nexavar-us.com]
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Abdominal Mass
They are usually asymptomatic at diagnosis but may present with an abdominal mass and distension, vomiting, anaemia and failure to thrive in a child under the age of 3 years. [patient.info]
Cholangiocarcinoma is associated with sweating, jaundice, abdominal pain, weight loss and liver enlargement. [9] Hepatocellular carcinoma is associated with abdominal mass, abdominal pain, emesis, anemia, back pain, jaundice, itching, weight loss and [en.wikipedia.org]
Patients with HCA usually come to medical attention when symptoms develop, with an abdominal mass (25–35%), chronic or episodic abdominal pain (20–25%), and acute abdominal pain due to hemorrhage into the tumor or into the peritoneal cavity (30–40%) frequent [nature.com]
Liver, Gall & Pancreas
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Jaundice
As a result of this blockage, bile fluids seep into the bloodstream and lead to jaundice, a yellowing of the skin and eyes. [livestrong.com]
ascites, jaundice ) rather than the tumor itself. Potentially curative treatment options include tumor resection, liver transplantation, and ablative therapies. [amboss.com]
Many of these symptoms can be caused by a variety of health problems, with the exception of yellow skin or jaundice. [my.clevelandclinic.org]
Jaundice If you develop jaundice, the whites of your eyes and your skin take on a yellow tinge. In some cases your urine may become darker and your stools (faeces) may become pale. [breastcancercare.org.uk]
When symptoms do appear, they can include: Jaundice — The first, and sometimes only, sign of a liver tumor is a yellow discoloration of the skin and whites of the eyes caused by high levels of bile pigment (bilirubin) in the blood. [froedtert.com]
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Hepatomegaly
Liver metastases are suspected in patients with weight loss and hepatomegaly or with primary tumors likely to spread to the liver. [msdmanuals.com]
] [3] Clinical features Usually asymptomatic apart from symptoms of the underlying disease (mostly cirrhosis or hepatitis ) Metastasis is uncommon and usually only occurs in advanced stages Possible symptoms in advanced disease Weight loss, cachexia Hepatomegaly [amboss.com]
Presentation [ edit ] Hepatomegaly - with a nodular free edge of liver Tenderness Cachexic Ascites Jaundice Pyrexia - up to 10% of patients Alkaline Phosphatase ( ALP ) and gamma glutamyl transpeptidase (GGT) elevated Ultrasound scan and CT scan - multiple [en.wikipedia.org]
Presentation Hepatomegaly and ascites are present in about half of patients with liver metastases. Nodularity may be palpable along the enlarged liver edge. Ascites indicates wide dissemination and a poor prognosis. [patient.info]
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Hepatic Mass
We sought to evaluate the feasibility of using endoscopic ultrasonograhpy (EUS) for the detection and diagnosis of hepatic masses in patients with hepatocellular cancer (HCCA) and metastatic lesions (ML). [ncbi.nlm.nih.gov]
Computerized tomography (CT) of the abdomen showed a hepatic mass. CT-guided FNAC and biopsy of the hepatic mass confirmed the diagnosis of primary HCC. Cirrhotic changes were not evident. [cytojournal.com]
In view of the raised AFP, a large liver mass and a characteristic osteolytic lesion in sternum with biopsy suggestive of HCC, the diagnosis was confirmed and an FNAC from the hepatic mass was not required. [jcmtjournal.com]
FLC characteristically manifests as a 10-20 cm large hepatic mass in adolescents or young adults. The typical risk factors for HCC such as cirrhosis, elevated alphafetoprotein, viral hepatitis, alcohol abuse are absent. [radiologyassistant.nl]
The diagnosis in patients without tissue proof was confirmed using the radiological criteria of the presence of a hepatic mass greater than 2 cm identified on one dynamic imaging technique with a typical vascular pattern [ 3 ]. [bmccancer.biomedcentral.com]
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Liver Tenderness
Presentation [ edit ] Hepatomegaly - with a nodular free edge of liver Tenderness Cachexic Ascites Jaundice Pyrexia - up to 10% of patients Alkaline Phosphatase ( ALP ) and gamma glutamyl transpeptidase (GGT) elevated Ultrasound scan and CT scan - multiple [en.wikipedia.org]
Skin
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Photosensitivity
Adverse events were generally limited to injection site reactions and photosensitivity and resolved without sequelae, with elevated liver enzymes observed during the first week after treatment. [ecancer.org]
Urogenital
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Dark Urine
urine from jaundice Fever If you’re experiencing any of these symptoms, it’s important to seek proper evaluation and treatment from a healthcare expert experienced in the diagnosis and treatment of liver cancer. [hoag.org]
Patients may also experience dark urine and itching. Patients with advanced liver cancer may also experience delirium, acute confusion that can be accompanied by behavioral changes. Liver failure, cause by advanced liver cancer, causes delirium. [livestrong.com]
Symptoms that may become apparent include: A bloated or swollen abdomen A lump or a heavy feeling in the upper abdomen Loss of appetite and feelings of fullness Weight loss Feeling weak or very tired Yellow skin and eyes, pale stools, and dark urine from [my.clevelandclinic.org]
urine from an accompanying medical condition called jaundice Fever Liver Cancer Treatment Treatment for primary liver cancer depends on multiple factors, including: The number, size, and location of tumors in your liver How well your liver is working [cooperhealth.org]
urine Fever Many other health problems can also cause these signs. [healthcare.utah.edu]
Workup
Liver metastases are usually asymptomatic and found during workup of a malignancy which has presented in other ways. [radiopaedia.org]
[…] changes include cholesterol, RBCs and sex changes Lab AFP, PIVKA II–protein induced by the absence of vitamin K, biopsy, hepatitis serology, LFTs, CBC, coagulation profile Imaging MRI, CT with angiography, CTs of head, chest, bone scan for metastastatic workup [medical-dictionary.thefreedictionary.com]
Serum
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Albumin Decreased
Diagnosis [ edit ] Hemoglobin decrease Liver function test : ALP elevated, bilirubin elevated, albumin decrease Carcinoembryonic antigen for colorectal secondaries Ultrasound scan CT scan Biopsy under ultrasound control Cross section of a human liver, [en.wikipedia.org]
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Alkaline Phosphatase Increased
An elevated level of alkaline phosphatase, increased retention of sulfobromophthalein, and the presence of alpha-fetoprotein in the blood suggest liver cancer. [medical-dictionary.thefreedictionary.com]
Treatment
Abstract The efficacy of hepatic arterial infusion chemotherapy (HAICT) in the treatment of primary or metastatic liver carcinoma was evaluated in 37 patients. [ncbi.nlm.nih.gov]
For this reason, it appears a worthwhile task to review the current status of knowledge about the treatment of primary and metastasizing tumors of the liver. [books.google.com]
With an estimated 400,000 new cases of HCC in China each year and 372,000 deaths, he adds, there is an urgent need for new treatments. [ecancer.org]
Seven guidelines were focused on a single treatment [13], [16], [19], [26], [27], [50], [52]. [journals.plos.org]
Prognosis
Unfortunately, this patient has a fairly poor prognosis. They’re presenting with an incurable lesion. That’s not to say it can’t be treated, and we can certainly extend this patient’s survival. [targetedonc.com]
The present of hepatic metastases, retained as an element of poor prognosis by several authors [ 4 et 5 ] has less impact on prognosis than LDH [ 12 ]. [em-consulte.com]
This review presents a case report that illustrates the distinctive pathological features of metastatic HCC, along with a brief review of pathological features, staging, treatment and prognosis. [ncbi.nlm.nih.gov]
However, if there is co-existing extensive extrahepatic disease, prognosis is usually guarded. Prognosis Deposits from colorectal cancer seem to have a better prognosis. [patient.info]
Knowing the stage helps the doctor decide what kind of treatment is best and may help predict a patient's prognosis. There are different stage descriptions for different types of cancer. [cancer.net]
Etiology
Etiology Liver cirrhosis (80% of cases) Risk factors independent of cirrhosis Chronic hepatitis B or C virus infection Nonalcoholic steatohepatitis ( NASH ) Hemochromatosis Wilson's disease Alpha-1 antitrypsin deficiency Schistosomiasis Glycogen storage [amboss.com]
The median survival is approximately 6 months, with 5-year survival of 29 Etiology Possible etiologic factors are much less well established than for HCC, and most cases have no known etiology, but it is clear that disorders that cause chronic inflammation [nature.com]
Etiology Cirrhosis In general, cirrhosis of any etiology is the major risk factor for hepatocellular carcinoma. [1, 2] About 80% of patients with newly diagnosed hepatocellular carcinoma have preexisting cirrhosis. [emedicine.medscape.com]
Chronic viral hepatitis, particularly hepatitis B, has been the most common etiological factor. [ 1 ] Hematogenous extra-hepatic metastases are commonly seen in lungs, lymph nodes, kidneys, adrenals, and bones. [jcmtjournal.com]
It is strongly associated with cirrhosis, from both alcohol and viral etiologies. HCC constitutes approximately 5% of all cancers partly due to the high endemic rates of hepatitis B infection 1. [radiopaedia.org]
Epidemiology
Epidemiology Fifth most common malignancy worldwide Highest incidence in Southeast Asia and Africa Peak incidence in the US: 70–75 years Peak incidence in Africa and Asia: 30–40 years References: [1] Epidemiological data refers to the US, unless otherwise [amboss.com]
Colorectal Cancer Epidemiology: Incidence, Mortality, Survival, and Risk Factors. Clin Colon Rectal Surg. 2009 November; 22(4): 191–197. [bead.btg-im.com]
Cancer epidemiology 38, 448–454, 10.1016/j.canep.2014.04.004 (2014). 18. Mitry, E. et al. Epidemiology, management and prognosis of colorectal cancer with lung metastases: a 30-year population-based study. [nature.com]
*SEER Surveillance, Epidemiology, and End Results [cancer.org]
"Hepatitis B and C virus infection and hepatocellular carcinoma in China: A review of epidemiology and control measures". Journal of Epidemiology. 21 (6): 401–416. doi : 10.2188/jea.JE20100190. PMC 3899457. PMID 22041528. "Pathophysiology". [en.wikipedia.org]
Pathophysiology
Thus, it is equally important to discuss the pathophysiological and pharmacological bases for a modem therapy concept as it is to consider diagnostic issues and possible definitions of stages of progression. [books.google.com]
Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 96. National Cancer Institute website. [medlineplus.gov]
The pathophysiological mechanisms of paraneoplastic itch are poorly understood. In pruritus caused by hepatobiliary tumors, cholestasis from tumor compression of the draining bile ducts is often the cause. [jddonline.com]
In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. . Accessed Feb. 22, 2016. Rizvi S, et al. [mayoclinic.org]
Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis, 9e. Philadelphia, PA: Elsevier; 2010. –s0015. Accessed April 3, 2014. Liver Cancer. National Cancer Institute website. . Accessed April 3, 2014. [innerbody.com]
Prevention
So, while the US Preventive Task Force does not necessarily recommend HCC screening because there aren’t well-done randomized perspective studies that have delineated that screening improves outcomes, most of the subspecialty societies still have a strong [targetedonc.com]
Fortunately, it is possible to prevent hepatitis via vaccination; the hepatitis B vaccine (below) was the first preventive cancer vaccine developed (in 1982). There is currently no vaccine to prevent hepatitis C virus (HCV) infection. [cancerresearch.org]
[…] toxicology conference in MENA region March 21, 2018 News Emory University School of Medicine seniors participate in Match Day 2018 March 16, 2018 News Emory Genetics Metabolic Nutrition Program launches new website for Medical Nutrition Therapy for Prevention [emoryhealthcare.org]
Prevention There's no way to prevent cholangiocarcinoma (bile duct cancer). But you may reduce your risk of the disease if you: Stop smoking. Smoking is linked to an increased risk of cholangiocarcinoma. If you smoke, stop. [mayoclinic.org]