Case Studies: The Liver, Biliary System and Pancreas: Case 3: Hepatocellular Carcinoma

A 66-year old man with past history of viral hepatitis (20 years ago).

    Chief complaints:
    • Upper abdominal pain.
    • Distended abdomen.
    • Edema of legs.
    Physical findings:
    • Weak, appears cachectic.
    • Enlarged liver.
    • Ascites.
    • Splenomegaly.
    • Abdominal tap revealed blood in ascites.
    Laboratory findings:
    • Low serum albumin.
    • Elevated alpha-fetoprotein (40 mg/dl).
    • Blood sugar 80 mg/dl.

Gross appearance of the tumor.

Another histologic slide illustrating the histologic features of liver cell carcinoma. Note the similarity between these neoplastic and normal hepatocytes.

This slide illustrates a liver with numerous tumor nodules. Are these primary or metastatic tumor nodules?

Cross section of a liver showing numerous metastatic nodules. Note the central "umbilicus" of the nodules. Where would you look for the primary tumor?

Question for Class Discussion

  • Discuss hepatitis B virus a risk factor for hepatocellular carcinoma.

    First Name: (required; no spaces)
    Last Name: (required; no spaces)