The patient is presenting with a fairly large mass in the liver. We are not told what its imaging characteristics are. [targetedonc.com]

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]

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]

Image courtesy of Mikael Häggström / Wikimedia Commons / CC-BY-SA-3.0 The majority of liver metastases present as multiple tumors. Only 10% of all cases present with a solitary metastatic lesion. [surgery.ucsf.edu]

Metastatic hepatocellular carcinoma presenting as gynecomastia in male: A diagnostic dilema in fine needle aspiration cytology 1 Department of Pathology, P.D.U. [cytojournal.com]

• 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 can include fatigue, loss of appetite, hand-foot syndrome (redness and irritation of the hands and feet), high blood pressure, fever, infections, weight loss, diarrhea, and abdominal (belly) pain. [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]

• 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]

  Common side effects can include fatigue, loss of appetite, hand-foot syndrome (redness and irritation of the hands and feet), high blood pressure, fever, infections, weight loss, diarrhea, and abdominal (belly) pain. [cancer.org]

• Ascites

  Serum bilirubin values of 10 mg/100 ml absence of ascites, extreme cachexia and impending hepatic failure were used as the criteria for admission of these patients into the study. [ncbi.nlm.nih.gov]

  Most patients typically present with symptoms caused by underlying disease (e.g., ascites, jaundice ) rather than the tumor itself. Potentially curative treatment options include tumor resection, liver transplantation, and ablative therapies. [amboss.com]

  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]

  If the cancer is contained within one lobe of the liver, and if the patient does not have either cirrhosis, jaundice, or ascites, surgery is the best treatment option. [medical-dictionary.thefreedictionary.com]

• Aspiration

  Right breast fine-needle aspiration cytology (FNAC) showed a cellular aspirate having numerous naked nuclei and large cohesive fragments of polygonal cells. [cytojournal.com]

  If liver lesions were confirmed and fine needle aspiration (FNA) was deemed necessary, a linear array scope was used and an FNA performed with a 22-gauge needle. Two passes were made for each lesion. [ncbi.nlm.nih.gov]

  Depending on the size of the tumor or mass, your physician may recommend the biopsy be taken one of several ways: By using a minimally invasive surgical technique known as laparoscopy By fine needle or thick needle aspiration (a core biopsy), using a [hopkinsmedicine.org]

  A biopsy is done by either: fine needle aspiration, which involves a local anaesthetic, and a thin needle which removes the cells; or laparoscopy (keyhole surgery), which is done under general anaesthetic and allows the doctor to look at the liver and [cancer.org.au]

  Platelet count (×109/L) 260 Serum creatinine (mg/dL) 0.6 Blood urea level (mg/dL) 22 Serum bilirubin (mg/dL) 1.0 SGOT (mg/dL) 125 SGPT (mg/dL) 168 Alkaline phosphatase (U) 360 HIV Negative HBsAg Positive HCV Negative Serum AFP (ng/dL) 34,300 Fine needle aspiration [jcmtjournal.com]

• Loss of Appetite

  Common side effects can include fatigue, loss of appetite, hand-foot syndrome (redness and irritation of the hands and feet), high blood pressure, fever, infections, weight loss, diarrhea, and abdominal (belly) pain. [cancer.org]

  Not eating enough because of loss of appetite can lead to problems like weight loss, a weakened immune system and fatigue. There are several ways to manage loss of appetite and make sure you are getting enough nutrition. [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]

• 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]

  Tell your doctor right away if you get high fever, nausea, vomiting or abdominal (stomach) pain. wound healing problems. If you have a surgical or dental procedure, tell your doctor you are taking NEXAVAR. [nexavar-us.com]

  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]

• 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]

• Right Upper Quadrant Tenderness

  upper quadrant tenderness Ascites and jaundice References: [3] [4] Diagnostics Laboratory tests ↑ Serum alpha-fetoprotein ( AFP ) Laboratory studies consistent with hepatitis and cirrhosis (e.g., ↑ LFTs, positive hepatitis serologies, ↓ coagulation factors [amboss.com]

• 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]

  Most patients typically present with symptoms caused by underlying disease (e.g., 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]

• Hepatomegaly

  Liver metastases are suspected in patients with weight loss and hepatomegaly or with primary tumors likely to spread to the liver. [msdmanuals.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]

  ] [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 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]

• Liver Mass

  CONCLUSIONS: Our preliminary experience suggests that EUS is a feasible preoperative staging tool for liver masses suspected to be HCCA or metastatic lesions. EUS can detect small hepatic lesions previously undetected by dynamic CT scans. [ncbi.nlm.nih.gov]

  We provide treatment options for people with: Primary liver cancers, such as hepatocellular carcinoma, bile duct cancer, and gallbladder cancer Metastatic cancer to the liver, such as metastatic colon cancer Benign (noncancerous) liver masses Chronic [upmc.com]

  Imaging Contrast-enhanced studies using ultrasound, MRI, or CT are most useful in the evaluation of a liver mass Ultrasound : first test Abdominal CT ( confirmatory test ): typically shows a single hypodense lesion with irregular borders and possible [amboss.com]

  In view of raised AFP, characteristic liver mass and biopsy of sternal mass, the diagnosis of HCC with sternal metastasis was confirmed. [jcmtjournal.com]

  Other less common liver cancers include carcinosarcomas, teratomas, yolk sac tumours, carcinoid tumours and lymphomas. [34] Lymphomas usually have diffuse infiltration to liver, but It may also form a liver mass in rare occasions. [en.wikipedia.org]

• 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]

• 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]

Liver metastases are usually asymptomatic and found during workup of a malignancy which has presented in other ways. [radiopaedia.org]

[…] 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]

• 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]

• Hypoglycemia

  References: [3] [4] Diagnostics Laboratory tests ↑ Serum alpha-fetoprotein ( AFP ) Laboratory studies consistent with hepatitis and cirrhosis (e.g., ↑ LFTs, positive hepatitis serologies, ↓ coagulation factors) Paraneoplastic syndromes : erythroc ytosis, hypoglycemia [amboss.com]

• 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]

When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. [cancer.gov]

Treatment overview In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. [cancer.net]

This is called palliative treatment. Deciding about treatment Deciding about treatment can be difficult. [cancerresearchuk.org]

However, treatment for children is different than treatment for adults. See the PDQ summary on Adult Primary Liver Cancer Treatment for more information on the treatment of adults. [northshore.org]

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 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 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 [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]

"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]

*SEER = Surveillance, Epidemiology, and End Results [cancer.org]

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. http://www.clinicalkey.com. Accessed Feb. 22, 2016. Rizvi S, et al. [mayoclinic.org]

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]

Prevention [ edit ] Prevention of cancers can be separated into primary, secondary, and tertiary prevention. Primary prevention preemptively reduces exposure to a risk factor for liver cancer. [en.wikipedia.org]