Hepatoma is primary liver cancer which occurs in the liver itself and did not spread from another area of the body to the liver. Often associated with cirrhosis of liver and hepatitis B infections, malignant hepatoma is common among alcoholics. It is found in people above 40 years of age and more noticed among men than women.
While the exact cause of malignant hepatoma is not known, there are several risk factors that contributes to the cause of hepatoma. These include being above 40 years of age, male sex, history of cirrhosis and exposure to hepatitis viruses B, C, D and G. Symptoms of malignant hepatoma may be the same as other liver diseases, including pain and swelling in the abdominal area, loss of weight, appetite, jaundice, fatigue and fever. Crucial pain extending to the back and shoulder is another symptom, when the cancer progresses. A collection of fluid known as ascites in the abdomen occurs in some patients, while some show signs of bleeding in the digestive tract.
The procedure for diagnosis is for the medical practitioner to go through the medical history of the patient first and physically examine the patient's abdomen for lumps if any. The liver could be swollen, hard and sore. Certain diagnostic parameters inclusive of blood tests are conducted to determine and evaluate the liver condition and function. An ultrasound and CT scan are undertaken to detect possible tumors in the liver. If necessary, a sample of liver tissue is sent for a biopsy to confirm if the hepatoma is malignant. Sometimes, a doctor looks for chest x-ray to understand if the liver tumor is primary or has spread to the lungs as well.
Hepatomas are neither contagious nor hereditary. They could be cured, if detected in the early stages. But unfortunately, most hepatomas are detected late making the rate of survival very low. In most advanced stages, malignant hepatoma cannot be cured although treated to relieve pain. Surgery is recommended if cancer is contained in one lobe of the liver and the patient is healthy enough without afflictions of cirrhosis, jaundice or ascited. Sometimes, chemotherapy or radiation therapy is undertaken to destroy the cancer cells in order to slow the disease spread. Although chemotherapy is not very successful but is tried in patients whose tumor is too large or advanced to be surgically resected. Liver transplant is adopted in patients who suffer acute liver damage with too large a portion of the tumor in the liver.
Malignant hepatoma, which is primary cancer of the liver is termed hepatocarcinoma. Hepatocarcinoma is secondary in about 20% to either a viral hepatitide infection (hepatitis B and C) and about 80% to cirrhosis. In some cases, it is metastasis of cancer, spread from elsewhere in the body. It is also associated with chronic alcohol abuse. Hepatocellular carcinoma is relatively rare in the United States but quite common in the African and Southeast Asian countries. In fact, this is the fifth most common tumor worldwide. In some African countries the disease onsets between late teens and 30s although the normal occurrence is in patients over age 50. Hepatocarcinoma is more common in males than females.
Hepatocarcinoma patients are put under surveillance with ultrasound. Possibly the best method of diagnosis involves a CT scan of the abdomen. This is done using intravenous contrast agent and three phase scanning, enabling the radiologist to detect subtle tumors as well. Another possible alternative to a CT imaging is MRI, using contrast agents which is used to detect the presence of a tumor capsule. Diagnosis is further confirmed by percutaneous biopsy and histopathological parameters.
Treatment for hepatocarcinoma depends especially on the size of the tumor and staging. Some of the treatment options are liver transplantation, which is to replace the liver with a cadaver liver or a live donor lobe; surgical resection wherein the tumor is removed if diagnosed early; Percutaneous ethanol injections in case of solitary tumors and transcatheter arterial chemoembolization for large tumors.
Sometimes sealed source radiotherapy is used to destroy the tumor from within. Here, the radioactive particles are deposited to the area of interest using a catheter. Radio frequency ablation uses high frequency radio waves to ablate the tumor. As an adjuvant therapy in resected patients, intra-arterial-iodine-131-lipiodol administration is performed. High intensity frequency ultrasound is a relatively new but powerful technique used to treat the tumor. Hormonal therapy and adjuvant chemotherapy are other treatment modalities adopted. Cryosurgery is yet another new technique that can destroy tumors in a variety of sites, in the brain, breast, kidney, prostate and liver.
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Collection of Pages - Last revised Date: March 20, 2023