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Hepatocellular Carcinoma Presentation

Hepatocellular carcinoma (HCC) is the most common primary liver cancer, accounting for approximately 90% of cases, with higher prevalence in males and regions with high HBV rates. Key risk factors include chronic hepatitis infections, cirrhosis, and exposure to aflatoxin, while diagnosis typically involves elevated serum alpha-fetoprotein and imaging techniques. Treatment options vary from surgical resection to systemic therapies, and prevention strategies focus on vaccination and risk factor management.

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Divyanshi Ojha
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79 views13 pages

Hepatocellular Carcinoma Presentation

Hepatocellular carcinoma (HCC) is the most common primary liver cancer, accounting for approximately 90% of cases, with higher prevalence in males and regions with high HBV rates. Key risk factors include chronic hepatitis infections, cirrhosis, and exposure to aflatoxin, while diagnosis typically involves elevated serum alpha-fetoprotein and imaging techniques. Treatment options vary from surgical resection to systemic therapies, and prevention strategies focus on vaccination and risk factor management.

Uploaded by

Divyanshi Ojha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

Hepatocellular Carcinoma (HCC)

Pathology Seminar
Referenced from Robbins Basic
Pathology
Introduction and Epidemiology
• - Hepatocellular carcinoma (HCC) is the most
common primary liver cancer.
• - Accounts for ~90% of all primary liver
cancers.
• - More common in males and in Asia & sub-
Saharan Africa due to high HBV prevalence.
• - Increasing incidence in the West due to HCV,
alcohol, and NAFLD.
Etiology
• - Chronic Hepatitis B and C infection
• - Cirrhosis (alcoholic, viral, NAFLD)
• - Aflatoxin B1 exposure
• - Genetic disorders: Hemochromatosis, alpha-
1 antitrypsin deficiency
• - Metabolic syndrome, diabetes
Pathogenesis
• - Repeated liver cell injury → regeneration +
inflammation → mutations
• - HBV integrates into host DNA, causing
genomic instability
• - p53 mutations (especially with aflatoxin
exposure)
• - Activation of oncogenes, telomerase
reactivation
Gross Features
• - Solitary, multifocal or diffusely infiltrative
mass
• - Usually yellow-white with areas of necrosis
or hemorrhage
• - May invade portal/hepatic veins →
metastasis
• - Often arises in cirrhotic background
Microscopy
• - Cells resemble normal hepatocytes but show
abnormal architecture
• - Trabecular, pseudoglandular, or solid growth
patterns
• - Increased nuclear-cytoplasmic ratio,
prominent nucleoli
• - Bile production may be seen
Variants
• - Fibrolamellar carcinoma: younger patients,
no cirrhosis
• - Clear cell, scirrhous, and pleomorphic
variants
Clinical Features
• - Often asymptomatic in early stages
• - Weight loss, abdominal pain, hepatomegaly
• - Jaundice (late), ascites
• - Sudden worsening in cirrhotic patients
Diagnosis
• - Serum alpha-fetoprotein (AFP) elevated in
50-70%
• - Imaging: Ultrasound, CT, MRI
• - Biopsy rarely needed if imaging + AFP are
diagnostic
Staging and Spread
• - TNM staging used
• - Local invasion and vascular spread common
• - Lung, bone, and lymph node metastasis
possible
Prognosis
• - Poor if detected late
• - Better prognosis in fibrolamellar variant
• - Prognosis depends on tumor size, spread,
liver function
Treatment
• - Surgical resection (if localized)
• - Liver transplantation
• - Local ablative therapies (RFA, TACE)
• - Systemic therapy (sorafenib,
immunotherapy)
Prevention
• - HBV vaccination
• - Screening in high-risk groups (cirrhotics)
• - Control of risk factors (alcohol, obesity, viral
infections)

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