Hepatocellular carcinoma - Revision history

Ostermayer: Prepared the page for translation

2026-01-04T23:02:27Z

Prepared the page for translation

← Older revision		Revision as of 23:02, 4 January 2026
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	<languages/>		<languages/>
	<translate>		<translate>


	==Background==		==Background==
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	{{Hemorrhoid background}}		{{Hemorrhoid background}}
	<translate>		<translate>



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	{{Internal Hemorrhoid Chart}}		{{Internal Hemorrhoid Chart}}
	<translate>		<translate>



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	**[[Special:MyLanguage/Internal hemorrhoid\|Internal hemorrhoid]]		**[[Special:MyLanguage/Internal hemorrhoid\|Internal hemorrhoid]]
	**[[Special:MyLanguage/External hemorrhoid\|External hemorrhoid]]		**[[Special:MyLanguage/External hemorrhoid\|External hemorrhoid]]



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	*[[Special:MyLanguage/Anorectal disorders\|Anorectal disorders]]		*[[Special:MyLanguage/Anorectal disorders\|Anorectal disorders]]



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	[[Category:GI]]		[[Category:GI]]

	</translate>		</translate>

Ostermayer: Prepared the page for translation

2026-01-04T23:01:28Z

Prepared the page for translation

← Older revision		Revision as of 23:01, 4 January 2026
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			<languages/>
			<translate>

	==Background==		==Background==
	*Most common form of liver cancer<ref>Current status of surgery and transplantation in the management of hepatocellular carcinoma: an overview. Pal S, Pande GK. J Hepatobiliary Pancreat Surg. 2001; 8(4):323-36.</ref>
	**5 new cases per 100,000 in western countries
	**> 100 per 100,000 in Southeast Asia and sub-Saharan Africa
	*Mean survival of 6-20 months, steady over the years despite progress in diagnosis and therapies directed at HCC
	*Surgical resection with transplantation, remains the best chance for cure
	**However, < 20% of patients meet criteria for resection at time of diagnosis<ref>Liver transplantation for hepatocellular carcinoma. Bismuth H, Majno PE, Adam R. Semin Liver Dis. 1999; 19(3):311-22.</ref>
	**Thus, early diagnosis is the most important step in managing HCC

	~~==Clinical Features==~~		</translate>
	*Risk factors include:		{{Hemorrhoid background}}
	**[[viral hepatitis\|Hepatitis]] B or C		<translate>
	**Toxins ([[alcohol]] or aflatoxin)
	**Metabolic conditions ([[hemochromatosis]], [[alpha 1-antitrypsin deficiency]], [[non-alcoholic fatty liver disease]])

	~~==Differential Diagnosis==~~
	===Liver mass<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>===
	*Regenerating nodule
	*Hemangioma
	*Focal fat
	*Dysplastic nodules
	*Peliosis

	~~{{Jaundice DDX}}~~		==Types==

	~~==Evaluation==~~		[[File:M 44 anus 22.jpg\|thumb\|[[Special:MyLanguage/External hemorrhoid\|External hemorrhoid]]]]
	[[File:~~Triphasic CT scan of hepatocellular carcinoma~~.jpg\|thumb\|~~Triphasic contrast CT of hepatocellular carcinoma.~~]]		[[File:Perianal thrombosis 01.jpg\|thumb\|Thrombosed [[Special:MyLanguage/external hemorrhoid\|external hemorrhoid]]]]
	*[[~~LFTs~~]]~~, CBC, BMP, GGT~~		*[[Special:MyLanguage/Internal hemorrhoid\|Internal hemorrhoid]]
	*[[~~RUQ Ultrasound~~\|~~Ultrasound~~]]		**Originate above the dentate line
	*~~Initial contrasted CT~~		**Painless
	*~~Multiphasic contrasted CT and MRI non-emergently~~		*[[Special:MyLanguage/External hemorrhoid\|External hemorrhoid]]
	*~~Biopsy~~		**Originate below the dentate line
	*Surveillance with alfa-fetoprotein (AFP > 400 ng/~~mL) in combination with US<ref~~>~~Bialecki ES and Di Bisceglie AM. Diagnosis of hepatocellular carcinoma. HPB (Oxford). 2005; 7(1): 26–34.~~<~~/ref~~>		**Painful
			</translate>
			{{Internal Hemorrhoid Chart}}
			<translate>

	~~==Management==~~
	*Supportive, symptomatic treatment for complications and comorbidities
	**Cirrhotic [[jaundice]]
	**[[Hepatic encephalopathy]]
	**[[Anasarca]]
	**[[Variceal bleeding]]
	**[[Renal failure]]
	**Extrahepatic metastases, most commonly bone, lung, abdominal viscera
	**[[Paraneoplastic]] processes, such as [[hypoglycemia]], [[hypocalcemia]], polycythemia, feminization syndrome
	**Watery [[diarrhea]], [[dehydration]] are common in HCC with cirrhosis versus cirrhosis alone

	==~~Disposition~~==		==Treatment==
	*~~Discussion with oncologist for first time diagnosis~~
	*~~Dependent on complications and comorbidities~~		*Increase fiber
			*Sitz baths
			*Topical steroid - Hydrocortizone
			*Topical anti-spasmodic - Nifedipine
			*See also treatment by specific type:
			**[[Special:MyLanguage/Internal hemorrhoid\|Internal hemorrhoid]]
			**[[Special:MyLanguage/External hemorrhoid\|External hemorrhoid]]


	==See Also==		==See Also==

	~~==External Links==~~		*[[Special:MyLanguage/Anorectal disorders\|Anorectal disorders]]


	==References==		==References==

	<references/>		<references/>

	[[Category:GI]]		[[Category:GI]]
	~~[[Category:Heme~~/~~Onc]]~~		</translate>

Rossdonaldson1: /* Liver massHelical 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. */

2021-07-08T20:30:31Z

Liver massHelical 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.

← Older revision		Revision as of 20:30, 8 July 2021
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	===Liver mass<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>===		===Liver mass<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>===
	*Regenerating nodule		*Regenerating nodule
	Hemangioma		*Hemangioma
	*Focal fat		*Focal fat
	Dysplastic nodules		*Dysplastic nodules
	*Peliosis		*Peliosis

Rossdonaldson1: /* Differential Diagnosis */

2021-07-08T20:30:15Z

Differential Diagnosis

← Older revision		Revision as of 20:30, 8 July 2021
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	==Differential Diagnosis==		==Differential Diagnosis==
	*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>		===Liver mass<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>===
			*Regenerating nodule
			Hemangioma
			*Focal fat
			Dysplastic nodules
			*Peliosis

	{{Jaundice DDX}}		{{Jaundice DDX}}

Rossdonaldson1: /* Differential Diagnosis */

2021-07-08T20:27:08Z

Differential Diagnosis

← Older revision		Revision as of 20:27, 8 July 2021
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Cirrhosis]]
	*[[Hepatitis]]
	*[[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>		*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>

Rossdonaldson1: /* Evaluation */

2021-07-08T20:25:22Z

Evaluation

← Older revision		Revision as of 20:25, 8 July 2021
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	==Evaluation==		==Evaluation==
			[[File:Triphasic CT scan of hepatocellular carcinoma.jpg\|thumb\|Triphasic contrast CT of hepatocellular carcinoma.]]
	*[[LFTs]], CBC, BMP, GGT		*[[LFTs]], CBC, BMP, GGT
	*[[RUQ Ultrasound\|Ultrasound]]		*[[RUQ Ultrasound\|Ultrasound]]

Rossdonaldson1: /* Differential Diagnosis */

2021-07-08T20:25:05Z

Differential Diagnosis

← Older revision		Revision as of 20:25, 8 July 2021
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	==Differential Diagnosis==		==Differential Diagnosis==
	~~[[File:Triphasic CT scan of hepatocellular carcinoma.jpg\|thumb\|Triphasic contrast CT of hepatocellular carcinoma.]]~~
	*[[Cirrhosis]]		*[[Cirrhosis]]
	*[[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>		*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>

			{{Jaundice DDX}}

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Differential Diagnosis */

2021-07-08T20:22:13Z

Differential Diagnosis

← Older revision		Revision as of 20:22, 8 July 2021
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	==Differential Diagnosis==		==Differential Diagnosis==
			[[File:Triphasic CT scan of hepatocellular carcinoma.jpg\|thumb\|Triphasic contrast CT of hepatocellular carcinoma.]]
	*[[Cirrhosis]]		*[[Cirrhosis]]
	*[[Hepatitis]]		*[[Hepatitis]]

ClaireLewis: /* Evaluation */

2019-10-01T00:57:24Z

Evaluation

← Older revision		Revision as of 00:57, 1 October 2019
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	==Evaluation==		==Evaluation==
	*[[LFTs]], CBC, BMP, GGT		*[[LFTs]], CBC, BMP, GGT
	*[[RUQ ~~ultrasound~~\|Ultrasound]]		*[[RUQ Ultrasound\|Ultrasound]]
	*Initial contrasted CT		*Initial contrasted CT
	*Multiphasic contrasted CT and MRI non-emergently		*Multiphasic contrasted CT and MRI non-emergently

ClaireLewis at 21:10, 29 September 2019

2019-09-29T21:10:10Z

← Older revision		Revision as of 21:10, 29 September 2019
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	==Clinical Features==		==Clinical Features==
	*Risk factors include:		*Risk factors include:
	**[[Hepatitis]] B or C		**[[viral hepatitis\|Hepatitis]] B or C
	**~~toxins~~ (alcohol or aflatoxin)		**Toxins ([[alcohol]] or aflatoxin)
	**Metabolic conditions ([[hemochromatosis]], [[alpha 1-antitrypsin deficiency]], [[non-alcoholic fatty liver disease]])		**Metabolic conditions ([[hemochromatosis]], [[alpha 1-antitrypsin deficiency]], [[non-alcoholic fatty liver disease]])

	==Differential Diagnosis==		==Differential Diagnosis==
	*Cirrhosis		*[[Cirrhosis]]
	*[[Hepatitis]]		*[[Hepatitis]]
	*[[Budd-Chiari syndrome]]		*[[Budd-Chiari syndrome]]
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	==Evaluation==		==Evaluation==
	*~~LFT~~, CBC, BMP, GGT		*[[LFTs]], CBC, BMP, GGT
	*Ultrasound		*[[RUQ ultrasound\|Ultrasound]]
	*Initial contrasted CT		*Initial contrasted CT
	*Multiphasic contrasted CT and MRI ~~nonemergently~~		*Multiphasic contrasted CT and MRI non-emergently
	*Biopsy		*Biopsy
	*Surveillance with alfa-fetoprotein (AFP > 400 ng/mL) in combination with US<ref>Bialecki ES and Di Bisceglie AM. Diagnosis of hepatocellular carcinoma. HPB (Oxford). 2005; 7(1): 26–34.</ref>		*Surveillance with alfa-fetoprotein (AFP > 400 ng/mL) in combination with US<ref>Bialecki ES and Di Bisceglie AM. Diagnosis of hepatocellular carcinoma. HPB (Oxford). 2005; 7(1): 26–34.</ref>
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	==Management==		==Management==
	*Supportive, symptomatic treatment for complications and comorbidities		*Supportive, symptomatic treatment for complications and comorbidities
	**Cirrhotic jaundice		**Cirrhotic [[jaundice]]
	**[[Hepatic encephalopathy]]		**[[Hepatic encephalopathy]]
	**[[Anasarca]]		**[[Anasarca]]
	**Variceal bleeding		**[[Variceal bleeding]]
	**Renal failure		**[[Renal failure]]
	**Extrahepatic metastases, most commonly bone, lung, abdominal viscera		**Extrahepatic metastases, most commonly bone, lung, abdominal viscera
	**[[Paraneoplastic]] processes, such as [[hypoglycemia]], [[hypocalcemia]], polycythemia, feminization syndrome		**[[Paraneoplastic]] processes, such as [[hypoglycemia]], [[hypocalcemia]], polycythemia, feminization syndrome