Hepatocellular carcinoma: Difference between revisions
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*LFT, CBC, BMP, GGT | *LFT, CBC, BMP, GGT | ||
*Ultrasound | *Ultrasound | ||
*Initial CT and MRI nonemergently | *Initial contrasted CT | ||
*Multiphasic contrasted CT and MRI nonemergently | |||
*Biopsy | *Biopsy | ||
*Surveillance with alfa-fetoprotein (AFP) 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) in combination with US<ref>Bialecki ES and Di Bisceglie AM. Diagnosis of hepatocellular carcinoma. HPB (Oxford). 2005; 7(1): 26–34.</ref> | ||
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
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[1]
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
- ↑ Bialecki ES and Di Bisceglie AM. Diagnosis of hepatocellular carcinoma. HPB (Oxford). 2005; 7(1): 26–34.