Hepatocellular carcinoma: Difference between revisions
| Line 11: | Line 11: | ||
*[[Hepatitis]] | *[[Hepatitis]] | ||
*[[Budd-Chiari syndrome]] | *[[Budd-Chiari syndrome]] | ||
*Liver masses - regenerating nodules, hemangiomas, focal fat, dysplastic nodules, peliosis<ref>Helical CT screening for hepatocellular carcinoma in patients with cirrhosis: frequency and causes of false-positive interpretation. Brancatelli G, Baron RL, Peterson MS, Marsh W. AJR Am J Roentgenol. 2003 Apr; 180(4):1007-14.</ref> | |||
==Evaluation== | ==Evaluation== | ||
*LFT, CBC, BMP, GGT | *LFT, CBC, BMP, GGT | ||
Revision as of 17:29, 13 October 2018
Background
- most common form of liver cancer
Clinical Features
- Risk factors include:
- Hepatitis B or C
- toxins (alcohol or aflatoxin)
- Metabolic conditions (hemochromatosis, alpha 1-antitrypsin deficiency, non-alcoholic fatty liver disease)
Differential Diagnosis
- Cirrhosis
- Hepatitis
- Budd-Chiari syndrome
- Liver masses - regenerating nodules, hemangiomas, focal fat, dysplastic nodules, peliosis[1]
Evaluation
- LFT, CBC, BMP, GGT
- Ultrasound
- Initial contrasted CT
- Multiphasic contrasted CT and MRI nonemergently
- Biopsy
- Surveillance with alfa-fetoprotein (AFP) in combination with US[2]
Management
- Supportive, symptomatic treatment for complications and comorbidities
- Cirrhotic jaundice
- Hepatic encephalopathy
- Variceal bleeding
- Renal failure
- Extrahepatic metastases, most commonly bone, lung, abdominal viscera
- Paraneoplastic processes, such as hypoglycemia, hypocalcemia, polycythemia, feminization syndrome
- Watery diarrhea, dehydration
Disposition
See Also
External Links
References
- ↑ Helical CT screening for hepatocellular carcinoma in patients with cirrhosis: frequency and causes of false-positive interpretation. Brancatelli G, Baron RL, Peterson MS, Marsh W. AJR Am J Roentgenol. 2003 Apr; 180(4):1007-14.
- ↑ Bialecki ES and Di Bisceglie AM. Diagnosis of hepatocellular carcinoma. HPB (Oxford). 2005; 7(1): 26–34.