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Metastatic Liver Carcinoma


Presentation

  • 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]
  • Liaw Hepatocellular carcinoma presenting as bone metastases Cancer, 64 (1989), pp. 1.753-1.757 [5.] D.L. Robinson, K.A. Davaiah, R.L. Lawton Hepatocellular carcinoma presenting as bone pain J Surg Oncol, 31 (1986), pp. 100-103 [6.] A. Chocarro, F.[archbronconeumol.org]
  • 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]
  • Abstract presented at: 2017 Gastrointestinal Cancers Symposium; January 19-21, 2017; San Francisco, CA.[onclive.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 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]
  • 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]
  • 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]
Fever
  • 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]
  • 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]
  • 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]
  • Complications of embolization include fever, abdominal pain, nausea, and vomiting. Radiation therapy : Radiation uses high-energy rays directed to the cancer to kill cancer cells. Normal liver cells are also very sensitive to radiation.[medicinenet.com]
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]
Coronary Artery Disease
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]
  • 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]
  • Patients typically present with symptoms which may include abdominal, shoulder or back pain, loss of appetite, weight loss, jaundice, and occasionally a palpable mass.The typical treatment is surgical removal of the tumor.[fibrofoundation.org]
  • […] of appetite change in thyroid hormone levels.[nexavar-us.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]
  • 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]
  • pain, appetite loss, nausea, and vomiting Metastasis to the lungs may cause: Chronic cough or inability to get a full breath Abnormal chest X-ray Chest pain Other nonspecific systemic symptoms of metastatic breast cancer can include fatigue, weight loss[nationalbreastcancer.org]
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]
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]
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]
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]
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]
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]
Dark Urine
  • 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]
Alkaline Phosphatase Increased
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]

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]
  • The median survival time for the responders was 7.2 months for patients with primary carcinoma and 9.4 months for patients with metastatic carcinoma of the liver as compared to 2 months for patients who failed to respond to the treatment.[ncbi.nlm.nih.gov]
  • 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]
  • In some cases, you may only require one treatment type. Other times your doctor may recommend a combination of treatments.[cooperhealth.org]

Prognosis

  • 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]
  • Treatment Prognosis 5-year survival rate Western countries: 27–49% Asia and Africa: 10%[amboss.com]
  • Prognosis A poor prognosis is associated with large tumour size, multifocal disease, extrahepatic disease and metastatic spread. [ 21 ] Older children and adults also tend to have a worse prognosis. [ 23 ] Cholangiocarcinoma See the separate Cholangiocarcinoma[patient.info]

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]

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]
  • "The epidemiology of hepatoblastoma". Pediatric Blood & Cancer. 59 (5): 776–9. doi : 10.1002/pbc.24215. PMID 22692949. a b Emre, S; McKenna, GJ (December 2004). "Liver tumors in children".[en.wikipedia.org]
  • Epidemiology Incidence increased (1.6/105 from 1980 to 4.9/105 from 2005), primarily in middle- to older-aged (age 40–60) patients; black patients are 2-fold more common than whites; male:female ratio is 3:1.[medical-dictionary.thefreedictionary.com]
Sex distribution
Age distribution

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]
  • 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]
  • Thorotrast exposure (historical), androgenic steroids, tyrosinemia Higher rates in blacks vs. whites (4:1); 70% male Most patients are age 60 years with cirrhosis or ages 20 - 40 years without cirrhosis, occasionally are second tumors in Wilm tumor patients Pathophysiology[pathologyoutlines.com]

Prevention

  • 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 [ 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]
  • Prevention Since primary liver cancer is often caused by cirrhosis, any measures that prevent chronic liver diseases and cirrhosis also prevent liver cancer.[innerbody.com]
  • Preventive measures include: Preventing and treating viral hepatitis may help reduce your risk. Childhood vaccination against hepatitis B may reduce the risk of liver cancer in the future. Do not drink excessive amounts of alcohol.[medlineplus.gov]

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