hepatocellular carcinoma

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carcinoma

 [kahr″sĭ-no´mah] (pl. carcinomas, carcino´mata)
a malignant new growth made up of epithelial cells tending to infiltrate surrounding tissues and to give rise to metastases. A form of cancer, carcinoma makes up the majority of the cases of malignancy of the breast, uterus, intestinal tract, skin, and tongue.
adenocystic carcinoma (adenoid cystic carcinoma) carcinoma marked by cylinders or bands of hyaline or mucinous stroma separated or surrounded by nests or cords of small epithelial cells, occurring in the mammary and salivary glands, and mucous glands of the respiratory tract. Called also cylindroma.
alveolar carcinoma bronchioloalveolar carcinoma.
basal cell carcinoma the most common form of skin cancer, consisting of an epithelial tumor of the skin originating from neoplastic differentiation of basal cells, rarely metastatic but locally invasive and aggressive. It usually occurs as small pearly nodules or plaques on the face of an older adult, particularly on a sun-exposed area of someone with fair skin. It has been divided into numerous subtypes on the basis of clinical and histological characteristics.
basosquamous carcinoma carcinoma that histologically exhibits both basal and squamous elements.
bronchioalveolar carcinoma (bronchiolar carcinoma) (bronchioloalveolar carcinoma) (bronchoalveolar carcinoma) a variant type of adenocarcinoma of the lung, with columnar to cuboidal epithelial cells lining the alveolar septa and projecting into alveolar spaces in branching papillary formations. Called also alveolar carcinoma or adenocarcinoma and bronchiolar, bronchioloalveolar, or bronchoalveolar adenocarcinoma.
bronchogenic carcinoma any of a large group of carcinomas of the lung, so called because they arise from the epithelium of the bronchial tree. Four primary subtypes are distinguished: adenocarcinoma of the lung, large cell carcinoma, small cell carcinoma, and squamous cell carcinoma.
cholangiocellular carcinoma a rare type of hepatocellular carcinoma arising from the cholangioles, consisting of two layers of cells surrounding a minute lumen. Called also bile duct carcinoma and cholangiocarcinoma.
chorionic carcinoma choriocarcinoma.
colloid carcinoma mucinous carcinoma.
cylindrical cell carcinoma carcinoma in which the cells are cylindrical or nearly so.
embryonal carcinoma a highly malignant germ cell tumor that is a primitive form of carcinoma, probably of primitive embryonal cell derivation; it usually arises in a gonad and may be found either in pure form or as part of a mixed germ cell tumor.
epidermoid carcinoma squamous cell carcinoma.
giant cell carcinoma a poorly differentiated, highly malignant, epithelial neoplasm containing many large multinucleated tumor cells, such as occurs in the lungs.
hepatocellular carcinoma primary carcinoma of the liver cells with hepatomegaly, jaundice, hemoperitoneum, and other symptoms of the presence of an abdominal mass. It is rare in North America and Western Europe but is one of the most common malignancies in parts of sub-Saharan Africa, Southeast Asia, East Asia, and elsewhere. A strong association seems to exist with chronic hepatitis B virus infection.
Hürthle cell carcinoma a malignant Hürthle cell tumor.
carcinoma in si´tu a neoplasm whose tumor cells are confined to the epithelium of origin, without invasion of the basement membrane; the likelihood of subsequent invasive growth is presumed to be high.
large cell carcinoma a type of bronchogenic carcinoma of undifferentiated (anaplastic) cells of large size, a variety of squamous cell carcinoma that has undergone further dedifferentiation.
medullary carcinoma that composed mainly of epithelial elements with little or no stroma.
mucinous carcinoma an adenocarcinoma that produces significant amounts of mucin.
nasopharyngeal carcinoma a malignant tumor arising in the epithelial lining of the nasopharynx, occurring at high frequency in people of Chinese descent. The epstein-barr virus has been implicated as a causative agent.
non–small cell carcinoma a general term comprising all lung carcinomas except small cell carcinoma, and including adenocarcinoma of the lung, large cell carcinoma, and squamous cell carcinoma.
oat cell carcinoma a form of small cell carcinoma in which the cells are round or elongated and slightly larger than lymphocytes; they have scanty cytoplasm and clump poorly.
papillary carcinoma carcinoma in which there are papillary growths that are irregular in nature arising from otherwise normal tissue; it can occur in the thyroid gland, the breast, or the bladder. Called also papillocarcinoma.
renal cell carcinoma carcinoma of the renal parenchyma, composed of tubular cells in varying arrangements; called also clear cell carcinoma.
scirrhous carcinoma carcinoma with a hard structure owing to the formation of dense connective tissue in the stroma. Called also fibrocarcinoma.
carcinoma sim´plex an undifferentiated carcinoma.
small cell carcinoma a common, highly malignant form of bronchogenic carcinoma in the wall of a major bronchus, occurring mainly in middle-aged individuals with a history of tobacco smoking; it is radiosensitive and has small oval undifferentiated cells. Metastasis to the hilum and to mediastinal lymph nodes is common.
spindle cell carcinoma squamous cell carcinoma marked by development of rapidly proliferating spindle cells.
squamous cell carcinoma
1. carcinoma developed from squamous epithelium, having cuboid cells and characterized by keratinization. Initially local and superficial, the lesion may later invade and metastasize.
2. the form occurring in the skin, usually originating in sun-damaged areas or preexisting lesions.
3. in the lung, one of the most common types of bronchogenic carcinoma, generally forming polypoid or sessile masses that obstruct the airways of the bronchi. It usually occurs in middle-aged individuals with a history of smoking. There is frequent invasion of blood and lymphatic vessels with metastasis to regional lymph nodes and other sites. Called also epidermoid carcinoma.
transitional cell carcinoma a malignant tumor arising from a transitional type of stratified epithelium, usually affecting the urinary bladder.
verrucous carcinoma
1. a variety of squamous cell carcinoma that has a predilection for the buccal mucosa but also affects other oral soft tissue and the larynx. It is slow-growing and somewhat invasive.
2. Buschke-Löwenstein tumor, so called because it is histologically similar to the oral lesion.

hepatocellular carcinoma (HCC),

[MIM*114550]
Malignant tumor of the liver that develops in the setting of chronic liver disease or cirrhosis. Hepatocellular carcinoma is derived from hepatocytes that are transformed into adenocarcinoma. Up to 60% of patients with HCC have elevated serum alpha fetoprotein levels. Tumor has a poor long-term prognosis unless treated surgically by resection or liver transplantation. Noninvasive imaging (e.g., MRI or CT scan) may distinguish hepatomas from other benign tumors such as hemangiomas.

hepatocellular carcinoma

(hĕp′ə-tō-sĕl′yə-lər, hĭ-păt′ō-)
n.
A carcinoma derived from parenchymal cells of the liver.

hepatocellular carcinoma

hepatocellular carcinoma

A primary liver cancer that arises in hepatocytes (liver cells).

Epidemiology
Incidence increased (1.6/105 from 1980 to 4.9/105 from 2005), primarily in middle- to older-aged (age 40–60) patients; black patients are 2-fold more common than whites; male:female ratio is 3:1. 

Clinical findings
Abdominal pain, weight loss, weakness, anorexia, vomiting, jaundice, hepatomegaly, ascites, splenomegaly, wasting, fever; paraneoplastic changes include increased cholesterol, polycythaemia and sex-discordant changes in hormone levels.
 
Risk factors
• HBV+ carries a 7-fold increased risk; HCV-ness carries a 4-fold increased risk.
• Mycotoxin (e.g., aflatoxin B1 in stored grains, drinking water).
• 3-year risk for HCC is 12.5% in patients with cirrhosis; 4% in patients with chronic liver disease; others include alcohol consumption, autoimmune chronic active hepatitis and cryptogenic cirrhosis.
• Metabolic diseases—Haemochromatosis, glycogen storage diseases, Wilson’s disease, galactosemia.
• Environmental conditions, such as excessive exposure to thorotrast (an obsolete radiocontrast medium), androgenic steroids, PVC (polyvinylchloride).

Lab
AFP, HepPAR, PIVKA II (protein induced by the absence of vitamin K), biopsy, hepatitis serology, LFTs, CBC, coagulation profile.
 
Prognosis
5-year postoperative recurrence is 80%, reflects adequacy of surgical margins, detected by AFP.

ma·lig·nant hep·a·to·ma

(mă-lig'nănt hep'ă-tō'mă)
A carcinoma derived from parenchymal cells of the liver.
Synonym(s): hepatocarcinoma, hepatocellular carcinoma.

Hepatocellular carcinoma

A dangerous cancer of the liver that may develop in patients who have had hepatitis, sometimes as long as 20 or 30 years earlier.
Mentioned in: Hepatitis C

carcinoma

a malignant new growth made up of epithelial cells tending to infiltrate surrounding tissues and to give rise to metastases. A form of cancer, carcinoma makes up the majority of the cases of malignancy of the mammary gland, uterus, intestinal tract, skin and tongue.

acinic cell carcinoma
locally invasive salivary gland tumors of dogs, and rarely other species, composed of glandular epithelium in an acinar pattern.
adenocystic carcinoma, adenoid cystic carcinoma
carcinoma marked by cylinders or bands of hyaline or mucinous stroma separated or surrounded by nests or cords of small epithelial cells, occurring in the mammary and salivary glands, and mucous glands of the respiratory tract. Called also cylindroma.
alveolar carcinoma
alveolar adenocarcinoma.
apocrine carcinoma
see apocrine tumors.
basal cell carcinoma
an epithelial tumor of the skin that seldom metastasizes but has potential for local invasion and destruction. Common in dogs and cats.
basosquamous carcinoma
carcinoma that histologically exhibits both basal and squamous elements.
bronchogenic carcinoma
carcinoma of the lung, so called because it arises from the epithelium of the bronchial tree.
cholangiocellular carcinoma
primary carcinoma of the liver originating in bile duct cells.
chorionic carcinoma
choriocarcinoma.
colloid carcinoma
mucinous carcinoma.
cylindrical cell carcinoma
carcinoma in which the cells are cylindrical or nearly so.
embryonal carcinoma
a highly malignant primitive form of carcinoma, probably of germinal cell or teratomatous derivation, usually arising in a gonad.
epidermoid carcinoma
that in which the cells tend to differentiate in the same way as those of the epidermis; i.e. they tend to form prickle cells and undergo cornification.
giant cell carcinoma
carcinoma containing many giant cells.
hepatocellular carcinoma
primary carcinoma of the liver cells.
Hürthle cell carcinoma
see hürthle cell tumor.
carcinoma in situ
a neoplastic entity wherein the tumor cells have not invaded the basement membrane but are still confined to the epithelium of origin; popularly applied to such cells in the uterine cervix.
large-cell carcinoma
a bronchogenic tumor of undifferentiated (anaplastic) cells of large size.
medullary carcinoma
that composed mainly of epithelial elements with little or no stroma.
mucinous carcinoma
adenocarcinoma producing significant amounts of mucin.
oat-cell carcinoma
small-cell carcinoma.
papillary carcinoma
carcinoma in which there are papillary excrescences; called also papillocarcinoma.
scirrhous carcinoma
carcinoma with a hard structure owing to the formation of dense connective tissue in the stroma.
carcinoma simplex
an undifferentiated carcinoma.
carcinoma of skin
squamous cell carcinomas occur on the third eyelid, cornea or the eyelid of cattle and horses, on the penis and prepuce of horses, from the mucosa of the frontal sinus to invade the horn core of cattle (called also horn cancer), on the ears of sheep, on the vulva of ewes when the tail is docked too short. In goats the ears, udder, base of the horn and perineum are also susceptible sites. The tumors grow rapidly, show considerable invasiveness and often metastasize to local lymph nodes. In dogs and cats, squamous cell carcinomas are common, particularly on the face and pinnae of white cats. See also squamous cell carcinoma (below).
small-cell carcinoma
a radiosensitive tumor composed of clusters of small, oval, undifferentiated cells that have hyperchromatic nuclei and scant cytoplasm and are typically bronchogenic. Called also oat-cell carcinoma.
spindle cell carcinoma
squamous cell carcinoma marked by fusiform development or rapidly proliferating cells.
stomach carcinoma
squamous cell carcinomas occur in the stomach of the horse and the bovine rumen. The associated clinical syndrome in the horse is one of indigestion and weight loss. Metastasis occurs commonly. In cows there may be vagus indigestion or chronic tympany of the rumen.
transitional cell carcinoma
occurs mainly in the urinary bladder of older dogs. Several structural types may be observed: papillary, polypoid, fungoid or sessile. Metastasis to regional lymph nodes and lungs is possible.
udder carcinoma
occurs rarely in mares and doe goats.
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