肝癌 | Notion

Any age; male > female, esp. when associated with cirrhosis
Usually presents with abdominal pain, ascites, hepatomegaly
Alpha-fetoprotein (AFP) levels often elevated in serum
Predisposing factors: cirrhosis, hepatitis B and C, Thorotrast (thorium dioxide), anabolic or progestational steroids (may be adenomas), alcohol, radiation, alpha1-antitrypsin deficiency, aflatoxins from fungus Aspergillus flaws, ataxia-telangiectasia syndrome, hemochromatosis
May be single large mass ("massive"), multiple discrete masses ("nodular"), or numerous small nodules scattered throughout the liver ("diffuse")
May be encapsulated, pedunculated, any size
Network of sinusoidal vessels surrounds tumor cells
Stroma usually scanty
Hepatocytes may be well differentiated to very bizarre
Vascular invasion common
Portal vein thrombosis found in a large percentage of cases
Prognosis poor: 10% survival at 5 yr
Good prognosis: low stage, encapsulation, single lesions, absence of cirrhosis, perhaps those associated with oral contraceptives