Hepatocellular Carcinoma12212210224242204

Hepatocellular Carcinoma

1. Hepatocellular Carcinoma (HCC) Prepared by : passant khaled

2. OUTLINES Introduction Definition Anatomy and functions of the liver Pathophysiology Causes and risk factors Signs and symptoms Diagnosis Complications Treatment Prevention

3. Introduction Hepatocellular Carcinoma (HCC ): is the most common type of primary liver cancer . A primary tumor of the liver and constitutes more than 90% of the primary tumor of the liver. Hepatocellular carcinoma occurs in approximately 85% of patients diagnosed with cirrhosis.

4. Globally, HCC is the sixth most common cancer and the third leading cause of cancer-related deaths

5. Definition Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. It originates in the hepatocytes , which are the main functional cells of the liver.

6. Anatomy and functions of the liver Understanding the surgical and interventional approach to the liver requires knowledge of its anatomy and vascular supply. The liver, the largest internal organ, constitutes 2-3% of an adult's body weight and is located in the right upper quadrant of the abdomen. It is surrounded by the inferior vena cava and connected to the diaphragm and peritoneum by ligaments. Its vascular supply comes from two main sources: the hepatic artery and the portal vein, both of which travel within the hepatoduodenal ligament.

7. the key functions of the liver Metabolism Detoxification Bile Production and Excretion Storage Synthesis of Plasma Proteins

8. Pathophysiology The pathophysiology of hepatocellular carcinoma (HCC) is complex and multifactorial . Initially, in 1981, hepatitis B virus (HBV) infection was linked to HCC, suggesting it as a primary cause. However, later studies indicated that HBV is not a major independent risk factor, as most HCC cases arise in patients with cirrhotic liver disease from various causes, including those without HBV markers. The malignant transformation involves multiple pathways influenced by external and environmental factors, leading to genetic changes that delay apoptosis and promote cellular proliferation.

9. Causes and Risk Factors Chronic Viral Hepatitis Hepatitis B Virus (HBV ) Hepatitis C Virus (HCV ) Cirrhosis. Most common Alcohol-related liver disease Non-alcoholic fatty liver disease (NAFLD ) Aflatoxin Exposure Metabolic Diseases

10. Signs and Symptoms General Symptoms Fatigue Weight loss Loss of appetite (anorexia): Abdominal Symptoms Abdominal pain Abdominal bloating or distension Palpable mass Jaundice

11. Signs and Symptoms Ascites Enlarged Liver ( Hepatomegaly ) Easy Bruising or Bleeding

12. Diagnosis Clinical Evaluation Medical History Physical Examination Blood Tests Alpha-fetoprotein (AFP) Liver Function Tests (LFTs) Imaging Techniques Ultrasound Computed Tomography (CT) Scan Magnetic Resonance Imaging (MRI)

13. Diagnosis Biopsy Limitations of Biopsy: Biopsy may not always be necessary if imaging features strongly suggest HCC, especially in cirrhotic patients, due to the risk of complications (e.g., bleeding) and the potential for sampling errors in cases of heterogeneous tumors.

14. Complications Liver Failure Portal Hypertension Metastasis (Spread of Cancer) Bile Duct Obstruction Coagulopathy (Bleeding Tendency) Ascites Hepatorenal Syndrome Pain and Cachexia Hepatic Encephalopathy

15. Treatment depend on the following Size, number, and location of tumors Presence or absence of cirrhosis Operative risk based on extent of cirrhosis and co morbid diseases Overall performance status Portal vein patency Presence or absence of metastatic disease

16. : Treatments include Surgery Ablation therapy Embolization Radiation therapy Immunotherapy Targeted therapy

17. Prevention There are several ways you can reduce your risk of developing HCC. You can : Get your hepatitis B vaccination, or get regular check-ups if you already have hepatitis B. See your healthcare provider if you think you may have been exposed to hepatitis C. (It’s curable with treatment .)

18. 3. Work with your provider to manage metabolic conditions associated with MASLD. Maintaining a weight that’s healthy for you by eating healthy foods is key. 4. Cut back on the amount of alcohol you drink. 5. Stop smoking if you do.