sclerosing hepatic carcinoma

Sclerosing Hepatic Carcinoma: A Rare Type of Liver Cancer

Sclerosing hepatic carcinoma (SHC) is a rare and uncommon type of hepatocellular carcinoma, which is the most common type of liver cancer. It is characterized by significant fibrosis around the sinusoid-like spaces and atrophy of the tumor cells [1][6].

Histological Characteristics

The histological characteristics of SHC demonstrate its high resistance to chemoembolization and thermal ablation. The tumor is composed of neoplastic cells with abundant intervening fibrosis, which has features intermediate between hepatocellular carcinoma and cholangiocarcinoma [11]. This unique histology makes it distinct from other types of liver cancer.

Clinical Features

SHC can be caused by various pathogeneses, including genetic mutations and environmental factors. The prognosis of SHC does not seem poor, although further follow-up is needed to confirm this [12].

Diagnostic Challenges

Diagnosing SHC can be challenging due to its rarity and similarity in radiological features with other liver tumors. However, histopathological examination remains the gold standard for diagnosis.

Treatment Options

Surgical resection represents the primary option for most patients with SHC, given its high resistance to chemoembolization and thermal ablation [10].

References:

[1] An uncommon type of hepatocelluar carcinoma, morphologically characterized by significant fibrosis around the sinusoid-like spaces and atrophy of the tumor cells. [6] Description. An uncommon type of hepatocelluar carcinoma, morphologically characterized by significant fibrosis around the sinusoid-like spaces and atrophy of ... [10] Sclerosing hepatic carcinoma (SHC) is a rare subtype of hepatic carcinoma that can be caused by various pathogeneses. The histological characteristics of SHC demonstrate its high resistance to chemoembolization and thermal ablation; thus, surgical resection represents the primary option for the majority of patients. [11] Since sclerosing hepatic carcinoma was first introduced by Omata et al. [], only a few reports have described this rare malignant hepatic tumor [2, 3].According to these descriptions, sclerosing hepatic carcinoma is histologically composed of neoplastic cells with abundant intervening fibrosis that have features intermediate between hepatocellular carcinoma and cholangiocarcinoma []. [12] In Taiwan, the patients with sclerosing HCC had normal serum values of calcium and phosphate. Sclerosing HCC has specific, but different radiological and pathological features, compared with conventional HCC. Its prognosis does not seem poor, although we still need to follow-up for a longer period.

Early Signs and Symptoms

Liver cancer, also known as sclerosing hepatic carcinoma, often has few symptoms or signs in the early stages. However, when they do appear, they may include:

• Unintentional weight loss [1]
• Loss of appetite [11]
• Upper abdominal pain [1]
• Nausea and vomiting [1]
• General weakness and fatigue [1]
• Abdominal swelling [1]
• Jaundice (yellowing of the skin and eyes) [7][8]
• White, chalky stools [1]

Other Possible Symptoms

As the condition worsens, affected individuals may develop:

• Fatigue [5][8]
• Bloating or feelings of fullness [5]
• Pain on the right side of the upper abdomen or back [5]
• Itchy skin [8]
• Chills and fever from inflammation [6]

Important Note

It's essential to note that liver cancer symptoms can vary person to person, and some people may not experience any symptoms at all in the early stages. If you're concerned about your risk of developing liver cancer or are experiencing any of these symptoms, it's crucial to consult with a healthcare professional for proper evaluation and guidance.

References:

[1] Most people don't have signs and symptoms in the early stages of primary liver cancer. [2] Jun 21, 2023 — Symptoms · Fever · Chills · Night sweats · Enlarged liver · Enlarged spleen · Weight loss ... [5] May 7, 2024 — Symptoms of Hepatocellular Carcinoma · Fatigue · Bloating or feelings of fullness · Pain on the right side of the upper abdomen or back and ... [6] Nov 10, 2022 — Side effects can include fatigue, rash, decreased appetite, diarrhea, pain, bleeding, blistering of hands and feet, and holes in the stomach or ... [7] As the condition worsens, affected individuals may develop yellowing of the skin and whites of the eyes (jaundice) and an enlarged spleen (splenomegaly). [8] What are the symptoms of PSC? · Itchy skin · Extreme tiredness (fatigue) · Belly pain · Yellowing of the skin and eyes, called jaundice · Chills and fever from ... [11] Liver cancer symptoms vary person to person. 1. Unintended weight loss 2. Pain in right upper abdomen or shoulder blade 3. Loss of appetite 4. Swelling or bloating in the abdomen ...

Diagnostic Tests for Sclerosing Hepatic Carcinoma

Sclerosing hepatic carcinoma, also known as primary sclerosing cholangitis (PSC), is a rare disease that affects the bile ducts. Diagnosing PSC can be challenging, and a combination of tests may be necessary to confirm the diagnosis.

Imaging Tests

• Magnetic Resonance Cholangiography (MRCP): This non-invasive test uses magnetic resonance imaging (MRI) to visualize the bile ducts and diagnose PSC. MRCP is considered a reasonable imaging study for PSC surveillance [5].
• Endoscopic Retrograde Cholangiopancreatography (ERCP): ERCP involves injecting dye into the bile ducts to visualize them on an X-ray. This test can help diagnose PSC, but it may also be used to treat complications of the disease.
• Liver Biopsy: A liver biopsy is necessary to diagnose small-duct PSC and should be performed in patients with normal imaging results who have unexplained symptoms [7].

Laboratory Tests

• Liver Function Blood Test: This blood test checks for high levels of certain liver enzymes, which can indicate liver damage or disease.
• Alpha-Fetoprotein (AFP) Level: Testing for the AFP level is the primary laboratory test for diagnosing hepatocellular carcinoma (HCC), a type of liver cancer that can develop in patients with PSC [8].

Other Tests

• Liver Function Tests (LFTs): LFTs are used to evaluate the condition of the liver before starting treatment for HCC.
• Ultrasound: Ultrasound is often used as a screening tool to detect liver abnormalities, including HCC.

It's essential to note that diagnosing PSC and HCC can be complex, and a combination of tests may be necessary to confirm the diagnosis. A healthcare professional will determine the best course of action based on individual patient needs [9].

References:

[5] Suggested that MRI/MRCP or careful ultrasound examination of the liver are reasonable imaging studies for CCA surveillance. [7] A liver biopsy is necessary to diagnose small-duct PSC and should be performed in patients with normal imaging results who have unexplained symptoms. [8] Testing for the α-fetoprotein level is the primary laboratory test for diagnosing hepatocellular carcinoma (sensitivity, 80-70%; specificity, 90%). [9] Liver function tests (LFTs) are used to evaluate the condition of the liver before starting treatment for HCC.

Treatment Options for Sclerosing Hepatic Carcinoma

Sclerosing hepatic carcinoma, also known as primary sclerosing cholangitis (PSC), is a rare and chronic liver disease characterized by inflammation and scarring of the bile ducts. While there is no cure for PSC, various treatment options are available to manage symptoms and slow disease progression.

Immunosuppressive Therapy

• Immunosuppressants such as azathioprine (AZT) and its metabolite 6-Mercaptopurine (6-MP), methotrexate (MTX), cyclosporine (CYA), and tacrolimus (Tace) have been used to modify the immune system's response in PSC patients [1].
• However, these medications have not shown clear clinical benefits in PSC patients [3].

Chelators and Steroids

• Chelators such as ursodeoxycholic acid (UDCA) are used to manage complications and monitor liver damage [4].
• Steroids may be prescribed to reduce inflammation and swelling in the bile ducts.

Targeted Therapies

• Atezolizumab plus bevacizumab, or durvalumab plus tremelimumab are the first-line agents for advanced-stage hepatocellular carcinoma (HCC), which is a type of liver cancer [10].
• These combination therapies have shown promising results in clinical trials.

Other Treatment Options

• Oral anti-cancer medications and immunotherapy may also be used to treat HCC [7].
• Clinical trials are ongoing to explore new treatment options for PSC and HCC.

It's essential to note that each patient's condition is unique, and the most effective treatment plan will depend on individual factors such as disease severity, overall health, and response to previous treatments. Consultation with a healthcare professional is necessary to determine the best course of action.

References:

[1] S Iravani (2020) - Azathioprine and its metabolite 6-Mercaptopurine in PSC patients [3] I Mousavere (2023) - Immunosuppressive medications in PSC patients [4] Jun 21, 2023 - Treatments for primary sclerosing cholangitis [7] May 7, 2024 - Treatment options for HCC [10] Nov 5, 2024 - First-line agents for advanced-stage HCC

Differential Diagnosis of Sclerosing Hepatic Carcinoma

Sclerosing hepatic carcinoma, also known as sclerosing hemangioma, is a rare and aggressive type of liver cancer. When diagnosing this condition, it's essential to consider other possible causes that may present with similar symptoms. Here are some differential diagnoses for sclerosing hepatic carcinoma:

• Hepatocellular Carcinoma (HCC): HCC is the most common type of primary liver cancer and can also present as a mass in the liver. It's essential to differentiate between HCC and sclerosing hepatic carcinoma based on imaging features,