Malaysia
Search
Sign In
Change Password
Points
Sign Out
Hepatocellular%20carcinoma Signs and Symptoms
Definition
- Cancer originating from the liver
Pathology
Types of Hepatocellular Carcinoma by Morphology
- Nodular: Characterized by nodules that are well-circumscribed and often associated with cirrhosis
- Massive: Occupies a large area that may or may not have satellite nodules in the surrounding liver; usually associated with noncirrhotic liver
- Diffuse: Less common type; characterized by diffuse involvement of many small indistinct tumor nodules throughout the liver
Signs and Symptoms
- Physical signs are hepatomegaly and ascites
- Usually asymptomatic for much of its natural history
- Nonspecific symptoms include:
- Jaundice
- Anorexia
- Weight loss
- Malaise
- Upper abdominal pain
Risk Factors
- Presence of cirrhosis is the key risk factor for the development of hepatocellular carcinoma
High-risk Groups for Hepatocellular Carcinoma Screening and Surveillance
- Asian male ≥40 years old who are hepatitis B carriers
- Asian female ≥50 years old who are hepatitis B carriers
- Hepatitis B carriers with family history of hepatocellular carcinoma
- Africans and African Americans with hepatitis B
- Cirrhotic hepatitis B and C carriers
- Alcoholic cirrhosis
- Nonalcoholic fatty liver disease
- Individuals with stage 4 primary biliary cirrhosis
- Individuals with genetic hemochromatosis and cirrhosis
- Individuals with alpha 1-antitrypsin deficiency and cirrhosis
- Individuals with cirrhosis from other etiologies
- Environmental exposure to aflatoxin which is a natural product of the Aspergillus fungus found in various grains
Epidemiology
- Liver cancer is the second most common cause of cancer-related mortality worldwide and hepatocellular carcinoma accounts for >90% of liver cancers
- It is the sixth most common cancer worldwide; 5th most common in males and 9th most common in females
- In Singapore, from 2009-2013, it is the 3rd most common cause of cancer death in males and 4th in females
- About 83% of new hepatocellular carcinoma cases in 2012 occurred in less developed countries with East and South Asia and Saharan Africa having the highest incidence; Northern Europe and South Central Asia have the lowest incidence
- Asia has the highest incidence of hepatocellular carcinoma relative to blacks, Hispanics and whites
- 71% of reported hepatic cancers worldwide are from Eastern (55.6%), South-Eastern (10.6%) and South-Central(5.2%) Asia
- There is a >2:1 ratio of male-to-female predominance
- Approximately 80% of hepatocellular carcinoma cases are caused by hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection especially in those with cirrhosis
