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Hepatoma (Hepatocellular Carcinoma)

Sarah Burroughs, DO Reviewed 06/2022
 


BASICS

DESCRIPTION

Hepatoma, (hepatocellular carcinoma [HCC]), is the most common primary malignant tumor of the liver, arising from hepatic parenchymal cells (hepatocytes); 80% are associated with und...

DIAGNOSIS

  • In children

    • Feminization, precocious puberty

    • Palpable liver mass, pain, asymmetrical hepatomegaly

  • In adults

    • Known cirrhosis or clinical signs of cirrhosis: 80%

    • Abdominal pain: 80%; right upper qu...

TREATMENT

MEDICATION

  • Targeted therapy with sorafenib offers a small survival benefit in patients with disease not amenable to surgical intervention; not effective as adjunctive to surgery (2)[B]

  • Treatm...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Even after successful resection, there is a high risk of recurrence. 
  • AFP level every 3 months

  • US every 4 to 6 months or contrast-enhanced CT/MRI ...

REFERENCES

1
Singal AG, Lampertico P, Nahon P. Epidemiology and surveillance for hepatocellular carcinoma: new trends. J Hepatol. 2020;72(2):250–261. doi: 10.1016/j.jhep.2019.08.025.
2
...

CODES

ICD10

C22.0 Liver cell carcinoma 

SNOMED

95214007 Primary malignant neoplasm of liver 

CLINICAL PEARLS

  • With benign liver tumors, most patients will have normal LFTs; 97% with HCC will have >1 abnormal test.

  • It is estimated that up to one-third of patients with cirrhosis will develop H...

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