A Case Presentation of Well-Differentiated Hepatocellular Carcinoma With No Sign of Liver Disease

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Abstract

The type of liver cancer that occurs most frequently is hepatocellular carcinoma (HCC). The majority of cases of HCC are secondary to alcoholic cirrhosis or viral hepatitis. The presence of malignant cells with modest nuclear atypia that resemble normal hepatocytes and the lack of bare nuclei in the smears, which shows the neoplastic hepatocytes' capacity, are characteristics of a well-differentiated HCC plasma membrane to tolerate smearing. We present the case of an 83-year-old male patient with a well-differentiated HCC, who had no etiological factors and no signs of alcohol cirrhotic liver, or any symptoms of liver disease which are the main causes of the HCC.

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A global view of hepatocellular carcinoma: trends, risk, prevention and management

Ju Yang, Pierre Hainaut, Gregory J. Gores … (2019)

Hepatocellular carcinoma (HCC) is the fourth most common cause of cancer-related death worldwide. Risk factors for HCC include chronic hepatitis B and hepatitis C, alcohol addiction, metabolic liver disease (particularly nonalcoholic fatty liver disease) and exposure to dietary toxins such as aflatoxins and aristolochic acid. All these risk factors are potentially preventable, highlighting the considerable potential of risk prevention for decreasing the global burden of HCC. HCC surveillance and early detection increase the chance of potentially curative treatment; however, HCC surveillance is substantially underutilized, even in countries with sufficient medical resources. Early-stage HCC can be treated curatively by local ablation, surgical resection or liver transplantation. Treatment selection depends on tumour characteristics, the severity of underlying liver dysfunction, age, other medical comorbidities, and available medical resources and local expertise. Catheter-based locoregional treatment is used in patients with intermediate-stage cancer. Kinase and immune checkpoint inhibitors have been shown to be effective treatment options in patients with advanced-stage HCC. Together, rational deployment of prevention, attainment of global goals for viral hepatitis eradication, and improvements in HCC surveillance and therapy hold promise for achieving a substantial reduction in the worldwide HCC burden within the next few decades.

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Hepatocellular carcinoma (HCC): Epidemiology, etiology and molecular classification.

Saranya Chidambaranathan-Reghupaty, Paul B. Fisher, Devanand Sarkar (2021)

Hepatocellular carcinoma (HCC), the primary malignancy of hepatocytes, is a diagnosis with bleak outcome. According to National Cancer Institute's SEER database, the average five-year survival rate of HCC patients in the US is 19.6% but can be as low as 2.5% for advanced, metastatic disease. When diagnosed at early stages, it is treatable with locoregional treatments including surgical resection, Radio-Frequency Ablation, Trans-Arterial Chemoembolization or liver transplantation. However, HCC is usually diagnosed at advanced stages when the tumor is unresectable, making these treatments ineffective. In such instances, systemic therapy with tyrosine kinase inhibitors (TKIs) becomes the only viable option, even though it benefits only 30% of patients, provides only a modest (~3months) increase in overall survival and causes drug resistance within 6months. HCC, like many other cancers, is highly heterogeneous making a one-size fits all option problematic. The selection of liver transplantation, locoregional treatment, TKIs or immune checkpoint inhibitors as a treatment strategy depends on the disease stage and underlying condition(s). Additionally, patients with similar disease phenotype can have different molecular etiology making treatment responses different. Stratification of patients at the molecular level would facilitate development of the most effective treatment option. With the increase in efficiency and affordability of "omics"-level analysis, considerable effort has been expended in classifying HCC at the molecular, metabolic and immunologic levels. This review examines the results of these efforts and the ways they can be leveraged to develop targeted treatment options for HCC.

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Hepatocellular carcinoma: old friends and new tricks

Eunsun Kim, Patrick Viatour (2020)

Hepatocellular carcinoma (HCC) is the most prevalent primary liver cancer and a leading cause of cancer-related deaths worldwide. Ninety percent of HCC cases arise from cirrhosis, during which liver cells undergo chronic cycles of necrosis and regeneration. The complex genomic landscape of HCC has been extensively investigated to draw correlations between recurrently mutated pathways and patient prognosis. However, our limited success with targeted therapy shows that knowing the presence of somatic mutations alone is insufficient for us to gauge the full spectrum of their functional consequences in the context of tumor evolution. In addition, the current molecular classification of HCC offers little information on the relationship between the molecular features and immunological properties of HCC tumors and their immune microenvironment. This review introduces current challenges and advancements made in HCC surveillance, diagnosis, and treatment. We also discuss the suite of HCC-associated genetic changes and describe recent studies that provide evidence for an evolving functional model and its implications for understanding and targeting HCC progression. Hepatocellular carcinoma (HCC) is the most common primary liver cancer worldwide, but despite advances in understanding disease genetics, successful targeted therapies are limited. Eunsun Kim at Stanford University and Patrick Viatour at the University of Pennsylvania reviewed current HCC surveillance, diagnostics and treatments, focusing on genetic changes and their influence on disease progression. Novel methods for HCC diagnosis, including analysis of cancer-derived materials in blood, will complement existing diagnostics and help identify more early stage cases. Extensive studies of HCC tumor ecosystems will inform the development of novel immunotherapies. More studies involving genetic sequencing of mutations within tumors over time should further advance our understanding of HCC progression and help explain varying treatment responses.

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Author and article information

Journal

Journal ID (nlm-ta): Cureus

Journal ID (iso-abbrev): Cureus

Journal ID (issn): 2168-8184

Title: Cureus

Publisher: Cureus (Palo Alto (CA) )

ISSN (Electronic): 2168-8184

Publication date (Electronic, pub): 4 June 2024

Publication date (Electronic, collection): June 2024

Volume: 16

Issue: 6

Electronic Location Identifier: e61635

Affiliations

[1 ] Medicine, Datta Meghe Institute of Higher Education and Research, Wardha, IND

[2 ] Pathology, Datta Meghe Institute of Higher Education and Research, Wardha, IND

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Prachi Gedekar prachigedekar7620@ 123456gmail.com

Article

DOI: 10.7759/cureus.61635

PMC ID: 11223716

PubMed ID: 38966460

SO-VID: 04f7298b-4288-4e50-a2b8-5bb2830a6470

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

A Case Presentation of Well-Differentiated Hepatocellular Carcinoma With No Sign of Liver Disease

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Abstract

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Most cited references 9

A global view of hepatocellular carcinoma: trends, risk, prevention and management

Hepatocellular carcinoma (HCC): Epidemiology, etiology and molecular classification.

Hepatocellular carcinoma: old friends and new tricks

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