Hepatocellular Carcinoma

HCC is the most common

primary form of liver cancer

HCC is not encountered as often as

metastatic liver disease

HCC is most commonly seen in

men, and frequently accompanied by cirrhosis or chronic hepatitis

the malignant mass associated with HCC is referred to as

a hepatoma

other causes of HCC

hemochromatosis, von gierke disease, and wilson disease

hepatomas can invade the

portal veins or hepatic veins

this older hematoma has become sonolucent. fresh hematomas may appear isoechoic to normal liver tissue

clinically, patients with HCC will have possible

abnormal liver function tests, signs of cirrhosis, history of chronic hepatitis, unexplained weight loss, hepatomegaly, fever, abdominal swelling with ascites, and perhaps a palpable mass

a tumor marker for HCC is

serum alpha-fetoprotein (AFP)

in the fetus, AFP is produced in

large amounts by the liver

in the adult (AFP)

low levels of AFP exist

most patients with HCC will have

elevated AFP

elevation of AFP occurs because

AFP is produced in excess by the malignant hepatocytes that make up the tumor

clinical findings of HCC

1. elevated AFP

2. abnormal liver function tests (possibly)

3. cirrhosis

4. chronic hepatitis

5. unexplained weight loss

6. hepatomegaly

7. fever

8. palpable mass

9. abdominal swelling with ascites

sonographic findings of HCC

1. solitary, hypoechoic mass

2. heterogenous masses scattered throughout the liver

3. mass with a hypoechoic halo and central echogenic portion (“target” or “bull’s-eye” lesion)

4. possible ascites