scholarly journals Hepatocellular Carcinoma with Cutaneous Metastases

2009 ◽  
Vol 23 (1) ◽  
pp. 23-25 ◽  
Author(s):  
Suzanne Rueben ◽  
David Owen ◽  
Patricia Lee ◽  
Alan Weiss

Two cases of cutaneous metastases from hepatocellular carcinoma (HCC) are reported. Both patients had been diagnosed with HCC at least one year before the appearance of skin lesions. The lesions presented as small reddish nodules in both patients, with a large additional vascular lesion in one of the patients. Cutaneous metastases from HCC are very rare. However, these two cases suggest that patients with HCC and presenting with skin nodules should have biopsies performed to confirm the diagnosis.

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Walid El Moghazy ◽  
Samy Kashkoush ◽  
Glenda Meeberg ◽  
Norman Kneteman

Background. We aimed to assess incidentally discovered hepatocellular carcinoma (iHCC) over time and to compare outcome to preoperatively diagnosed hepatocellular carcinoma (pdHCC) and nontumor liver transplants.Methods.We studied adults transplanted with a follow-up of at least one year. Patients were divided into 3 groups according to diagnosis of hepatocellular carcinoma.Results.Between 1990 and 2010, 887 adults were transplanted. Among them, 121 patients (13.6%) had pdHCC and 32 patients (3.6%) had iHCC; frequency of iHCC decreased markedly over years, in parallel with significant increase in pdHCC. Between 1990 and 1995, 120 patients had liver transplants, 4 (3.3%) of them had iHCC, and only 3 (2.5%) had pdHCC, while in the last 5 years, 263 patients were transplanted, 7 (0.03%) of them had iHCC, and 66 (25.1%) had pdHCC (P<0.001). There was no significant difference between groups regarding patient survival; 5-year survival was 74%, 75.5%, and 77.3% in iHCC, pdHCC, and non-HCC groups, respectively (P=0.702). Patients with iHCC had no recurrences after transplant, while pdHCC patients experienced 17 recurrences (15.3%) (P=0.016).Conclusions.iHCC has significantly decreased despite steady increase in number of transplants for hepatocellular carcinoma. Patients with iHCC had excellent outcomes with no tumor recurrence and survival comparable to pdHCC.


2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Peng Yuan ◽  
Peng Chen ◽  
Yeben Qian

Background.The long-term prognosis after curative therapy for hepatitis B virus- (HBV-) related hepatocellular carcinoma (HCC) remains unsatisfactory due to the high incidence of recurrence. The effect of treatment with nucleotide analogues (NAs) in patients with HBV-related HCC after curative therapy remains unclear.Objective.To assess the impact of using NAs after curative therapy.Method.A computerized literature search was performed; eligible studies were identified from databases. The pooled risk ratios (RRs) and 95% CIs were calculated using Review Manager 5.3.Result.The meta-analysis included a total of 15 studies with 8060 patients. The one-year and three-year recurrence (one-year recurrence: RR 0.41 [95% CI 0.28 to 0.61];P<0.00001; three-year recurrence: RR 0.63 [95% CI 0.43 to 0.94];P=0.001) and the one-, three-, and five-year overall survival (OS) and disease-free survival (DFS) were significantly better in the treatment group.Conclusion.NAs can reduce the recurrence and improve the prognosis of HBV-related HCC after curative therapy.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Nadia abdelaty Abdelkader ◽  
Moustafa Hamed Abdelaleem ◽  
Mohammed El-Gharib Abo El- maaty ◽  
Heba Ismail Aly ◽  
Sayed Ahmed Sayed

Abstract Background Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide and it is also a common cause of death in patients with chronic liver disease. The curative treatment options for HCC that are currently available are surgical resection, liver transplantation and radiofrequency ablation .Despite progressive improvements in the efficacy of RFA, the survival of patients with HCC who undergo RFA remains disappointing, mainly due to frequent intrahepatic recurrence of HCC after RFA. Aim of the work To evaluate the role of transient elastography (as an indirect indicator to degree of liver fibrosis) in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation in hepatitis C related hepatocellular carcinoma .And to compare between transient elastography and other non invasive fibrosis indices in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation hepatitis C related hepatocellular carcinoma Patients and methods This prospective cohrt study was conducted on hepatocellular carcinoma patient, who underwent radiofrequency ablation in Tropical Medicine Department in Eldemerdash and Ain Shams Specialized Hospital, HCC clinic Ain Shams University Hospitals, Cairo, Egypt between march, 2017 and May, 2019. Data of the patient, who underwent radiofrequency ablation during the study period, were reviewed and the patients who fulfilled the inclusion criteria were enrolled into this study. The patients who fulfilled the inclusion criteria and underwent radiofrequency ablation were followed up for 12 months. Results TE revealed 28 patients with F4 and only 2 patients with F3, the mean measurement of liver stiffness was (22.45 ± 10.36) KPa. There was a significant negative correlation between LS and denovo recurrence of HCC (mean of LS in patients with complete response was 17.19 ± 3.32 and the mean of LS in patient with denovo recurrence was 36,94 ± 5.93,with the The best cut off value ≥24.65 (p value &lt; 0.001)). There was no significant correlation between CDC, FIB4, API scores and denovo recurrence of HCC. Also it was found that the LS was significantly associated with prediction of manifestation of hepatic decompensation after RFA (means of LS in patient without manifestation decompensation after RFA (p value &lt;0.001) .Regarding prediction of mortality, LS at cut off value &gt; 42 .75 (p value = 0,031) was significantly associated with prediction of mortality after one year of RFA. As regard serum non invasive fibrosis indices our results showed correlation between FIB4 score and hepatic decompensation after one year of intervention (the mean of FIB4 score in patients ascites and jaundice was 6.05 ± 4.71 (p value = 0.05) ).Therewas no statistically significant correlation between CDS and API with hepatic decompensation after RFA .As regard role of serum non invasive fibrosis indices in prediction of mortality after RFA, FIB4 score, CDS and API were statistically non significant. Conclusion Our data suggest that LS measurement is a useful predictor of HCC de novorecurrence overall survival and possibility of hepatic decompensation after RFA


2021 ◽  
Author(s):  
Xiao-juan Zou ◽  
Lin Qiao ◽  
Feng Li ◽  
Hua Chen ◽  
Yun-jiao Yang ◽  
...  

Abstract ObjectiveTo investigate the clinical features of multicentric reticulohistiocytosis (MRH). MethodsThe clinical manifestations, laboratory examination results and histologic characteristics of eleven patients with MRH were collected and compared with those of 33 patients with rheumatoid arthritis. ResultsIn total, 72.7% of the MRH patients were women. The median age was 46 years (range: 33-84 years). Diagnosed by specific pathologic features, all MRH patients exhibited cutaneous involvement. The dorsa of the hands, arms, face and auricle were the most commonly affected areas. Nodules were also located on the legs, scalp, trunk, neck, and even the hypoglossis and buccal mucosa. Ten MRH patients (90.9%) had symmetric polyarthritis. Compared with rheumatoid arthritis (RA) patients, MRH patients were more likely to have distal interphalangeal joint (DIP) involvement (63.6% vs 24.2%, P=0.017) and less likely to have elbow (36.4% vs 72.7%, P=0.003), ankle (45.5% vs 93.9%, P<0.001) and metacarpophalangeal joint (MCP) (36.4% vs 78.8%, P=0.009) involvement. The positivity for rheumatoid factor (RF) (36.4% vs 84.6%, P=0.001) and anti-CCP antibody (9.1% vs 81.8%, P=0.000), as well as the median RF titer [43.8 (31.7-61.0) vs 175.4 (21.3-940.3), P = 0.021], in MRH patients was lower than that in RA patients. Elevation of the erythrocyte sedimentation rate (ESR) was also less common in MRH patients than in RA patients (36.4% vs 72.7%, P=0.030). After treatment with median- to large-dose corticosteroids and disease-modifying antirheumatic drugs, 8 patients achieved complete remission, and 2 patients achieved partial remission (skin lesions ameliorated, joint lesions not ameliorated). ConclusionAlways pathologically diagnosed, MRH is a systemic disease involving RA-like erosive polyarthritis and a specific distribution of skin nodules characterized by "coral beads". More DIP involvement and less elbow, ankle and MCP involvement are seen in MRH than in RA. In addition, less positive and lower-titer RF, uncommon presence of anti-CCP antibodies and ESR elevation may be helpful to distinguish MRH from RA.


2020 ◽  
Vol 7 (4) ◽  
pp. 179-184
Author(s):  
Sam Hajialiloo Sami ◽  
◽  
Farshad Zandrahimi ◽  
Mohamadreza Heidarikhoo ◽  
Mahsa Zahmatkesh ◽  
...  

Infantile fibrosarcoma is a rare soft-tissue neoplasm, which may render a diagnostic challenge leading to misdiagnosis and consequently an inappropriate treatment of patients. This study reports a case of infantile fibrosarcoma that mimicked a hemangioma in an 11-month-old girl. As the lesion signal in the MRI was not consistent with the diagnosis of hemangiomas, we performed a core needle biopsy, which its result was consistent with the diagnosis of infantile fibrosarcoma. The lesion was initially treated with surgical resection. However, the lesion recurred one year after the surgery. The recurrence was managed with debulking surgery. The fifth finger was necrotized during the hospitalization after the relapse surgery. Finally, the necrotic finger was amputated. Also, adjuvant chemotherapy was used to prevent further relapses. The 1-year follow-up of the patient was recurrence-free. These findings highlight the importance of considering infantile fibrosarcoma when an infant presents with a lesion that clinically mimics a vascular lesion.


2021 ◽  
Author(s):  
Thomas Ka-Luen Lui ◽  
Ka Shing, Michael Cheung ◽  
Wai Keung Leung

BACKGROUND Immunotherapy is a new promising treatment for patients with advanced hepatocellular carcinoma (HCC), but is costly and potentially associated with considerable side effects. OBJECTIVE This study aimed to evaluate the role of machine learning (ML) models in predicting the one-year cancer-related mortality in advanced HCC patients treated with immunotherapy METHODS 395 HCC patients who had received immunotherapy (including nivolumab, pembrolizumab or ipilimumab) in 2014 - 2019 in Hong Kong were included. The whole data set were randomly divided into training (n=316) and validation (n=79) set. The data set, including 45 clinical variables, was used to construct six different ML models in predicting the risk of one-year mortality. The performances of ML models were measured by the area under receiver operating characteristic curve (AUC) and the mean absolute error (MAE) using calibration analysis. RESULTS The overall one-year cancer-related mortality was 51.1%. Of the six ML models, the random forest (RF) has the highest AUC of 0.93 (95%CI: 0.86-0.98), which was better than logistic regression (0.82, p=0.01) and XGBoost (0.86, p=0.04). RF also had the lowest false positive (6.7%) and false negative rate (2.8%). High baseline AFP, bilirubin and alkaline phosphatase were three common risk factors identified by all ML models. CONCLUSIONS ML models could predict one-year cancer-related mortality of HCC patients treated with immunotherapy, which may help to select patients who would most benefit from this new treatment option.


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