Hepatocellular carcinoma is the most common primary malignant liver cancer. HCC arises from hepatocytes in the liver. Risk factors for developing HCC include viral infections (Hepatitis B and Hepatitis C), liver cirrhosis, aflatoxin exposure, Non Alcoholic Fatty Liver Disease (NAFLD), haemochromatosis and Wilson‘s Disease. The latter is an inherited disorder in which excessive amounts of copper accumulate in the body, particularly in the liver, brain, and eyes. HCC incidence is highest in Asia and sub Saharan Africa. There is a higher risk of developing HCC in males. HCC is associated with acquired driver mutation in oncogenes and tumour suppressor genes. The two most common driver mutations that can lead to HCC are gain-offunction mutations in beta-catenin and loss-of-function mutations in p53. Clinically HCC can present with abdominal pain, fatigue, weight loss, abdominal fullness and less commonly jaundice, gastrointestinal or variceal bleeding. HCC metastatic spread is haematogenous with lung, abdominal lymph nodes and bones being the most common extrahepatic sites. Death usually occurs from cachexia, haemorrhage or liver failure. Treatment varies on the stage of the tumour and the patient’s underlying general status and co-morbidities. Treatment can include surgical resection of ablation of the tumour, chemotherapy and liver transplantation can be curative.
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