Presentation
HCC presents a variable appearance at CT and MRI. [scielo.br]
How do liver abscesses present? Multiple abscesses tend to present more acutely and single ones more indolently. Liver symptoms: Right upper quadrant pain, tenderness, hepatomegaly, possible palpable mass. [brainscape.com]
The most common presentation is an asymptomatic mass. Patients may also present with abdominal pain, nausea, vomiting, weight loss, and/or fever. [cancertherapyadvisor.com]
Typically presenting with mass effect or incidentally on imaging, MCN-L is considered a premalignant transformation, requiring resection. [academic.oup.com]
present, this is referred to as liver adenomatosis. [appliedradiology.com]
Entire Body System
- Weakness
Are you feeling weak or tired? Is your appetite down? Have you lost weight ? Your doctor may use tests to help diagnose hepatocellular carcinoma: Blood test. [webmd.com]
Current techniques each have their strengths and weaknesses. Ultrasound Ultrasound is usually the first screening test carried out if HCC is suspected. [hepctrust.org.uk]
But, as the cancer grows, symptoms may include: • Pain in the upper abdomen on the right side; • Pain that may extend to the back and shoulder; • Swollen abdomen (bloating); • Loss of appetite and feelings of fullness; • Weakness or feeling very tired [secure.ssa.gov]
Targeted drugs attack specific weaknesses in the cancer cells, and they may help slow the progression of the disease in people with advanced liver cancers. Immunotherapy. [mayoclinic.org]
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]
- Fatigue
Side effects of sorafenib (Nexavar) include fatigue, rash, high blood pressure, sores on the hands and feet, and loss of appetite. [medicinenet.com]
Side effects can include: fatigue, rash, decreased appetite, diarrhea, pain, bleeding, blistering of hands and feet, and holes in the stomach or intestine. Immunotherapy. [webmd.com]
Patients may experience nausea, vomiting, and fatigue. Chemotherapy: Medications are injected into the liver to kill cancer cells. [medicalnewstoday.com]
Healthy Lifestyles Physical Activity Nutrition and Weight Management Supplement Use Immunizations and Infections Late Effects/Long-Term Psychosocial and Physical Problems Anthracycline-Induced Cardiac Toxicity Anxiety and Depression Cognitive Function Fatigue [nccn.org]
When signs and symptoms do appear, they may include: Losing weight without trying Loss of appetite Upper abdominal pain Nausea and vomiting General weakness and fatigue Abdominal swelling Yellow discoloration of your skin and the whites of your eyes [mayoclinic.org]
- Swelling
After being upright all day, the swelling disappears. When possible, treatment involves resolving the underlying cause. [en.wikipedia.org]
In later stages, cancer can cause the liver to swell or obstruct the normal flow of blood and bile. [healthline.com]
Liver cancer Inherited diseases, such as hemochromatosis and Wilson disease Symptoms of liver disease can vary, but they often include swelling of the abdomen and legs, bruising easily, changes in the color of your stool and urine, and jaundice, or yellowing [icdlist.com]
The main presenting manifestations are abdominal mass with pain, swelling and discomfort, weight loss, and anorexia. Splenomegaly, nausea, vomiting, and jaundice are less commonly observed. [orpha.net]
Respiratoric
- Cough
Shock and death in severe circumstances Call 911 if you have: Any serious injury to the chest Chest pain or shortness of breath Go to the emergency room or call the local emergency number (such as 911) if you have: Dizziness, lightheadedness, fever and cough [medlineplus.gov]
In this condition water retention is mostly visible in the legs, feet and ankles, but water also collects in the lungs, where it causes a chronic cough. [en.wikipedia.org]
Gastrointestinal
- Vomiting
Methods: Chart review and review of current multispecialty literature Results: We present a 61-year-old woman with 2-year history of episodic cholangitis, jaundice, and vomiting. [academic.oup.com]
Complications of chemotherapy include fatigue, easy bruising, hair loss, nausea and vomiting, swollen legs, diarrhea, and mouth sores. These side effects are usually temporary. [medicinenet.com]
The following symptoms indicate a more urgent and serious problem: persistent vomiting, meaning vomiting more than twice a day for more than one day blood in vomit recent, unexplained weight loss black bowel movements difficulty swallowing new swelling [healthline.com]
Patients may also present with abdominal pain, nausea, vomiting, weight loss, and/or fever. [cancertherapyadvisor.com]
Nausea and vomiting. Anorexia and weight loss. How are liver abscesses treated? US/CT guided drainage of the abscess + abx. A third generation cephalosporin (ceftriaxone) + an anti-amoebic (metronidazole) [brainscape.com]
- Nausea
Nausea and vomiting. Anorexia and weight loss. How are liver abscesses treated? US/CT guided drainage of the abscess + abx. A third generation cephalosporin (ceftriaxone) + an anti-amoebic (metronidazole) [brainscape.com]
Complications of chemotherapy include fatigue, easy bruising, hair loss, nausea and vomiting, swollen legs, diarrhea, and mouth sores. These side effects are usually temporary. [medicinenet.com]
Symptoms are more likely if they are > 4 cm; symptoms include discomfort, fullness, and, less often, anorexia, nausea, early satiety, and pain secondary to bleeding or thrombosis. These tumors often have a characteristic highly vascular appearance. [msdmanuals.com]
Patients may also present with abdominal pain, nausea, vomiting, weight loss, and/or fever. [cancertherapyadvisor.com]
The systemic toxicities of the FUDR HAI were nausea, vomiting, diarrhea and mucositis. The hepatic side effect was not detected. [kjg.or.kr]
- Abdominal Mass
The main presenting manifestations are abdominal mass with pain, swelling and discomfort, weight loss, and anorexia. Splenomegaly, nausea, vomiting, and jaundice are less commonly observed. [orpha.net]
Most commonly, symptoms include pain and sensation of an upper abdominal mass. Unusual presentation includes jaundice, cholangitis, intraperitoneal rupture, intracystic hemorrhage or compression of portal vein, among others (5). [scielo.isciii.es]
A palpable mass may be noticed by the patient. May present with severe, acute abdominal pain with bleeding into the abdomen, leading to shock. Other rare presentations include obstructive jaundice. [patient.info]
They may be discovered on medical imaging (even for a different reason than the cancer itself), or may be present in patients as an abdominal mass, hepatomegaly, abdominal pain, jaundice, or some other liver dysfunction. [en.wikipedia.org]
[…] sensitivity Abdominal US and AFP Multiphasic CT or MRI recommended in setting of positive AFP or liver mass on US Abdominal US AFP not recommended Recommended Interval for Screening Every 6 mos (can range from 4-8 mos) Markers plus US Super high risk [arupconsult.com]
Cardiovascular
- Hypertension
Ensure the best patient encounters and outcomes with 86 new downloadable Patient Teaching Guides online covering Acute Coronary Syndrome, Diabetes Insipidus, Electrical Injury, Pulmonary Hypertension and more! [books.google.ro]
Of the fibropolycystic liver diseases, patients with congenital hepatic fibrosis and Caroli disease often develop recurrent acute cholangitis and portal hypertension secondary to peribiliary fibrosis (Figure 1). [appliedradiology.com]
Because of the limitations of organ supply, liver transplantation is generally reserved for patients with unresectable tumors either due to location or presence of portal hypertension. [clinicaladvisor.com]
Nodular regenerative hyperplasia of the liver: an under-recognized cause of portal hypertension in hematological disorders. Am J Hematol 2004;75(4):225-30. López R, Barrera L, Vera A, Andrade R. [revistagastrocol.com]
- Heart Disease
Sore Throat, Urinary Retention, Valvular Heart Disease and Vegetative State. [books.google.ro]
A prospective study of coronary heart disease and the hemochromatosis gene (HFE) C282Y mutation: the Atherosclerosis Risk in Com-munities (ARIC) study. [richtlijnendatabase.nl]
Liver, Gall & Pancreas
- Hepatomegaly
Most are asymptomatic, but some cause hepatomegaly, right upper quadrant discomfort, or intraperitoneal hemorrhage. Most are detected incidentally on ultrasound or other scans (in Imaging Tests of the Liver and Gallbladder ). [msdmanuals.com]
MRI results are inconclusive For confirmed HCC Chest CT – evaluate for extrahepatic metastases Bone scan – when skeletal symptoms present Differential Diagnosis Abdominal pain Acute cholecystitis Acute pancreatitis Infectious diarrhea Parasitic Viral Hepatomegaly [arupconsult.com]
ALP isoenzyme test (Medical Encyclopedia) Ascites (Medical Encyclopedia) Diet - liver disease (Medical Encyclopedia) Hepatic encephalopathy (Medical Encyclopedia) Hepatomegaly (Medical Encyclopedia) Liver disease (Medical Encyclopedia) Liver scan (Medical [icdlist.com]
- Liver Mass
Benign Liver Mass Overview Benign (noncancerous) liver masses or lesions are relatively common in the liver. [upmc.com]
Soulen MC: Angiographic evaluation of focal liver masses. Semin Roentegenol 1995, 30 :362–374. CrossRef Google Scholar 46. Adson M: Mass lesions of the liver. Mayo Clin Proc 1986, 61 :362–368. PubMed Google Scholar 47. [link.springer.com]
They have connections to the biliary tree and are not true liver masses but can be confused with a cystic liver mass. [clinicaladvisor.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]
(B) Gross pathology showing a large, well-circumscribed mass with surrounding liver parenchyma. (C) Serial sectioning of the mass revealed a cyst-like appearance with clear serous fluid filling the central portion. [frontiersin.org]
- Hepatic Friction Rub
Occasionally, a hepatic friction rub or bruit develops. Occasionally, systemic metabolic complications, including hypoglycemia, erythrocytosis, hypercalcemia, and hyperlipidemia, occur. These complications may manifest clinically. [merckmanuals.com]
Skin
- Erythema
Physical exam should focus on signs of chronic liver disease (spider angioma, muscle wasting, firm liver, splenomegaly, palmer erythema, ascites, asterixis, altered mental status) and signs of malignancy (muscle wasting, abdominal or other masses, lymph [clinicaladvisor.com]
Psychiatrical
- Suggestibility
Suggested Listings for Evaluation: DETERMINATION LISTING REMARKS Meets 13.19 Prognosis is poor based on confirmed diagnosis alone Equals * Adjudicators may, at their discretion, use the Medical Evidence of Record or the listings suggested to evaluate [secure.ssa.gov]
This mode of delivery is based upon early reports suggesting that liver tumors primarily receive blood supply via hepatic artery ( 3 ). [academic.oup.com]
Significant increase in the size of the tumor and in alpha–fetoprotein serum levels suggests a diagnosis of malignant transformation (22,23). [scielo.br]
Urogenital
- Dark Urine
urine from jaundice; and I CD-9: 155.0, 155.1, 230.8 PROGRESSION Hepatocellular Carcinoma is rarely discovered early and often does not respond to current treatments-thus, the prognosis is often poor. [secure.ssa.gov]
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/grey pale stools (faeces) loss of sex drive (libido). [britishlivertrust.org.uk]
Neurologic
- Encephalopathy
ALP isoenzyme test (Medical Encyclopedia) Ascites (Medical Encyclopedia) Diet - liver disease (Medical Encyclopedia) Hepatic encephalopathy (Medical Encyclopedia) Hepatomegaly (Medical Encyclopedia) Liver disease (Medical Encyclopedia) Liver scan (Medical [icdlist.com]
Complications include: ascites (accumulation of fluid within the abdomen) encephalopathy (affliction of the brain due to liver failure) variceal haemorrhage or bleeding loss of blood due to portal hypertension, etc. [news-medical.net]
[…] resection, transplant) Metastatic disease common Common sites – lung, abdominal lymph nodes, bone Prognosis scoring systems Child-Pugh score – assessment of surgical risk in patients with cirrhosis Uses bilirubin, albumin, PT, and presence of ascites and encephalopathy [arupconsult.com]
Patient with clinically significant symptoms of hepatic encephalopathy 4. Patient who has previously received more than two line of systemic therapy. [clinicaltrialsregister.eu]
- Lethargy
Central nervous system abnormalities can eventually develop including mental status changes, lethargy, depression, and confusion, as consequence of severe hypercalcemia. [rarediseases.org]
Workup
Workup [ edit ] Upon discovery of a liver tumor, the main issue in the workup is to determine whether the tumor is benign or malignant. Many imaging modalities are used to aid in the diagnosis of malignant liver tumors. [en.wikipedia.org]
Hepatic adenomas are most often diagnosed as a result of imaging done for unrelated pathology or following workup of a palpable abdominal mass (30% patients) [ 88 ]. [intechopen.com]
The upright chest radiograph is the ideal primary diagnostic study in the evaluation of hemothorax (see Workup). [emedicine.medscape.com]
The combination of Hep Par 1 and MOC-31 will allow for the diagnosis of hepatocellular carcinoma in most cases and will guide the selection of immunohistochemical markers for further workup. [archivesofpathology.org]
Serum
- Hypoglycemia
The etiology of hypoglycemia in the adolescent includes a variety of disorders reviewed elsewhere (7). Insulinoma is not an infrequent cause of hypoglycemia in adolescents and its presence should always prompt consideration of MEN1. [jcrpe.org]
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]
Hypoglycemia mediated by paraneoplastic production of insulin like growth factor-2 from a malignant renal solitary fibrous tumor: clinical case and literature review. BMC Endocr Disord 2014; 14:49 [Google Scholar] 32. [ajronline.org]
[…] underlying cirrhosis Paraneoplastic syndromes – 20% of cases Acquired porphyria Cryofibrinogenemia Diarrhea – vasoactive intestinal polypeptide Erythrocytosis – erythropoietin-like activity Hypercalcemia – parathyroid-like hormone Hypercholesterolemia Hypoglycemia [arupconsult.com]
Biopsy
- Hepatocellular Carcinoma
We therefore developed a quantitative immunohistochemical assay and monitored epoxide hydrolase expression in hepatocellular carcinomas (HCC, n = 20), cholangio-cellular carcinomas (CCC, n = 2) and liver metastases (n = 57) of tumours of various origins [ncbi.nlm.nih.gov]
Aflatoxin B1 acts synergistically with hepatitis B virus in causing hepatocellular carcinoma. [scienceopen.com]
Expert consensus of the Standardized diagnosis and treatment for Hepatocellular carcinoma. J Clin Hepatol. 2009; 12 (5) 13. Zhang X, Zhou L, Chen B, Hu S, Wachtel MS, Frezza EE. [hepatmon.com]
NOS, Hepatocellular carcinoma NOS, [M]Hepatocellular carcinoma NOS, carcinoma of liver (diagnosis), hepatocellular carcinoma of liver (diagnosis), hepatocellular carcinoma of liver, liver neoplasm malignant carcinoma, carcinoma of liver, Liver carcinoma [fpnotebook.com]
Treatment
The treatment-related complication rate was 11.4 %. There was no treatment-related death. [aetna.com]
Treatment options differ for each type of cancer and your health is reliant upon receiving the proper cancer treatment. [liverandpancreassurgeon.com]
Treatment is rarely needed. Hemangiomas are usually small and asymptomatic; they occur in 1 to 5% of adults. [msdmanuals.com]
Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. [cancer.net]
Most benign liver tumors do not require treatment. State-of-the-art imaging and an expert opinion are essential to avoid unnecessary surgery and identify those rare cases that do require treatment. [nyp.org]
Prognosis
Prognosis Undifferentiated carcinomas are postulated to have a poorer prognosis than HCC, although evidence from more cases is needed to support this hypothesis. [atlasgeneticsoncology.org]
Prognosis is usually poor. Other primary liver cancers are uncommon or rare. Diagnosis usually requires biopsy. Prognosis is typically poor. Some cancers, if localized, can be resected. Resection or liver transplantation may prolong survival. [merckmanuals.com]
Prognosis The prognosis depends on success rates of resection in resectable tumors. 5-year survival rates are moderate in low stage tumors but these rates drop below 20-30% in advanced disease. [orpha.net]
Prognosis based on Tumor size and location (resectability) Tumor aggressiveness and growth rate Patient general health Liver function – degree of cirrhosis Available treatment options (eg, resection, transplant) Metastatic disease common Common sites [arupconsult.com]
Etiology
It is associated with inflammatory disorders and malformations of the ducts, but most cases are of unknown etiology. [ncbi.nlm.nih.gov]
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 Etiology is not well known. Epidemiology Undifferentiated carcinoma of the liver is very rare, accounting for less than 2% of all epithelial liver tumors. [atlasgeneticsoncology.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 [amboss.com]
From Wikimedia Commons, the free media repository Jump to navigation Jump to search Radiology: Ultrasound · X-ray · Computed tomography | Anatomical pathology: Cytopathology · Gross pathology · Histopathology | Other: Epidemiology (Geographic map → World [commons.wikimedia.org]
Chapters feature up-to-date information on the basic mechanisms, epidemiological risk factors, screening and surveillance strategies, diagnosis and treatment. [books.google.com]
The management of the network includes a Scientific Committee, an Executive Board and an Epidemiology and Management Coordinating Centre. http://chc.isped.u-bordeaux2.fr/ [icgc.org]
Pathophysiology
Simple cyst: pathophysiologically they are thought to be congenital. They are of no clinical significance and are often found incidentally. Polycystic liver disease: genetic disease usually associated with mutations of polycystic kidney disease. [brainscape.com]
Etiology The pathophysiology of hepatocellular carcinoma is not well understood. Underlying liver dysfunction is the main predisposing condition (HBV, HCV). [orpha.net]
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]
Amyloidosis and bleeding: Pathophysiology, diagnosis, and therapy. none Am J Kidney Dis. 2006; 47 :947–55. [ PubMed ] [ Google Scholar ] 4. Alwitry A, Brackenbury ET, Beggs FD, Soomro I. [ncbi.nlm.nih.gov]
Pathophysiology. Elsevier Health Sciences. pp. 660–. ISBN 978-0-323-29317-4. ^ Farage MA, Neill S, MacLean AB (2009). "Physiological changes associated with the menstrual cycle: a review". [en.wikipedia.org]
Prevention
[…] 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]
When doctors discover a large adenoma, they may recommend that it be surgically removed to prevent that possibility. [liverfoundation.org]
Related information Information for Health Professionals –Recommendations on Prevention and Screening for Liver Cancer Cancer Prevention Series (7) - Liver Cancer Prevention and Screening The Viral Hepatitis Preventive Service provides detailed information [chp.gov.hk]
[…] and early detection of cervical cancer: American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. [nccn.org]