1/18. Hepatocellular carcinoma arising in an elderly male with primary biliary cirrhosis.We report the case of an elderly male with asymptomatic primary biliary cirrhosis (PBC) who developed a hepatocellular carcinoma (HCC). The 89-year-old man, who was otherwise healthy, was admitted for investigation of mild hepatic dysfunction, which had been detected during a routine physical check-up. serum chemistry, positive anti-mitochondrial antibody (M2) and liver biopsy results led to a diagnosis of PBC. Three years later, at age 92, computed tomography (CT) and ultrasound scans of his abdomen revealed a large hepatic tumour, which was confirmed on liver biopsy to be HCC. The tumour ruptured 3 months after diagnosis and the patient was successfully stabilized by coil embolization of his right hepatic artery. We believe that, to date, this is the oldest reported patient to have had interventional radiology for the management of HCC.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/18. Aerobic exercise as additive palliative treatment for a patient with advanced hepatocellular cancer.Aerobic exercise is known to improve biopsychosocial outcomes in cancer patients. Currently, exercise is not regarded as a quality-of-life intervention for patients with advanced cancer. The aim of this case study was to determine the feasibility and effects of an aerobic exercise programme for a patient with advanced hepatocellular cancer. After written informed consent, a 55-year-old male patient with advanced hepatocellular carcinoma participated in an aerobic exercise programme of precise intensity, duration and frequency, consisting of ergometer cycling 2 times a week, carried out for a period of 6 weeks. exercise testing and a 6-min walk were performed, and the patient's quality of life was assessed. The feasibility, safety and beneficial effects of the programme were proven for this patient. At the end of the exercise programme, peak work capacity had increased by 20.3%. The patient has experienced an improvement in physical performance, which was underlined by the 6-min walk. quality of life has been improved (physical functioning, vitality, mental health, role functioning/emotional, social functioning). knowledge about the benefits of aerobic exercise for patients suffering from advanced cancer is not yet widespread. Nevertheless, aerobic exercise initiated and executed with appropriate care may serve as a useful additional means of palliative treatment in some patients with advanced cancer.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
3/18. Monophasic synovial sarcoma of the liver.We report a hepatic monophasic synovial sarcoma in a 60-year-old woman who presented with right upper quadrant pain subsequent to an intrahepatic bleed from a highly vascular tumor mass. Imaging studies showed a dominant tumor mass in the right hepatic lobe with multiple satellite nodules. A detailed physical examination and radiologic workup failed to reveal a primary tumor elsewhere. A right partial hepatectomy was performed with a preoperative differential diagnosis of angiosarcoma versus hepatocellular carcinoma. The morphologic, immunophenotypic, and cytogenetic findings (t(X;18)(p11.2;icq11.2)) were consistent with a monophasic synovial sarcoma. Postoperative clinical evaluation of the extremities and a positron emission tomographic scan performed 4 weeks after surgery showed no evidence of recurrent or metastatic disease. The patient was started on an aggressive 4-drug chemotherapy regimen, but died 3 months thereafter from widespread metastatic disease. No autopsy was performed. The presence of multiple lesions in the liver certainly suggests the possibility of metastatic disease. It would, however, be very unusual for a synovial sarcoma to present as an occult primary, and the negative radiologic workup 1 month after the partial hepatectomy also argues against this possibility. The clinical presentation, radiographic findings, and subsequent course in this patient was therefore most consistent with a primary monophasic synovial sarcoma of the liver.- - - - - - - - - - ranking = 8.425625keywords = physical examination, physical (Clic here for more details about this article) |
4/18. Fibrolamellar carcinoma of the liver--a case report.A 36-year-old woman was admitted to our hospital because of general fatigue. The physical and laboratory findings on admission revealed splenomegaly, pancytopenia, hypocoagulopathy, liver hypofunction with a hepaplastin test of 55% and ICG Rmax of 0.6 mg/kg/min. diagnostic imaging showed a hypoechoic mass 1.5 in diameter a low density area on the CT scan and a faint tumor stain on the AAG in the posterior inferior area of the liver. On a diagnosis of hepatocellular carcinoma with liver cirrhosis and hypersplenism, partial hepatectomy and splenectomy were performed. The resected hepatic specimen revealed a small liver cancer of 1.9 x 1.5 x 1.3 cm with liver cirrhosis. The specimen consisted of a firm rubbery mass. Macroscopically, the tumor appeared oval and was lobulated with a thin capsule. A fibrous scar was observed in the central area. Microscopically, malignant hepatocytes showed various shapes, ranging from polygonal to spindle form, with eosinophilic granular cytoplasm and were surrounded by abundant fibrous stroma. Orcein stain, revealed that these malignant hepatocytes contained many black granules of copper-binding protein. Immunoperoxidase staining for alpha 1-antitrypsin was also positive in the malignant hepatocytes. However, within this lamellar fibrous regions, there were many cords of tumor cells in which nucleoli were absent and abortive biliary differentiation was suggested. Consequently this tumor was diagnosed as an atypical fibrolamellar hepatocellular carcinoma. We think that this case is the 3rd case reported in japan and the 2nd case in a Japanese person.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/18. Hepatocellular carcinoma in childhood. Clinical manifestations and prognosis.From December 1964 to November 1989, 71 children from 3 to 17 years of age with the eventual diagnosis of hepatocellular carcinoma (HCC) presented at the National taiwan University Hospital (Taipei, taiwan, Republic of china). Forty-three of them had pathologic proof, whereas 28 were diagnosed on a clinical and laboratory basis. A male predominance (M:F = 3.2:1) was noticed. Most patients presented in a late, advanced stage. abdominal pain and abdominal mass were the major symptoms and signs, followed by anorexia, fever, and internal bleeding. Hydrocele, purpura, and obstructive jaundice were rare presenting symptoms. Hepatosplenomegaly, superficial venous engorgement, and ascites were the main physical signs. The prognosis for such children with HCC was very poor. Only 10% of the patients survived longer than 1 year after the onset of the initial symptom. Among 49 patients who could be followed, only two had long-term survival of over 5 years. One patient had a small HCC with internal bleeding, whereas the other had a large HCC with abdominal distention. Both received surgical resection, and a resection was repeated for tumor recurrence in the patient with the large mass. The resectability of these 71 patients was low (9.8%). Resectability and nonicterus seemed to be the factors indicating favourable prognosis. observation indicated that the prognosis for children with symptomatic HCC is grave but surgical resection, whenever possible, should be carried out.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/18. Total laparoscopic right posterior sectionectomy for hepatocellular carcinoma.A 57-year-old man presented with a liver mass that had been detected on physical examination. The abdominal computed tomography scan revealed a 5-cm single nodular hepatoma located in segments 6 and 7. A total laparoscopic right posterior sectionectomy was performed for this lesion. The anatomical demarcation of the posterior section was possible with selective control of a Glissonian pedicle to that section. The patient was discharged on postoperative day 13 without complications. The postoperative pathology confirmed a hepatocellular carcinoma with a 1-cm free resection margin. The patient had no evidence of recurrence at 12-month follow-up. To our knowledge, this is the first reported case of total laparoscopic right posterior sectionectomy in segments 6 and 7.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/18. Fibrolamellar hepatocellular carcinoma: a case report with cytological features in a sixteen-year-old girl.We report a case of a 16-yr-old girl with a liver tumor revealed by thrombophlebitis of the left leg. On physical examination the patient was found to have painless hepatomegaly. Ultrasound and CAT scan showed a large tumor of the left portion of the liver, measuring 14 cm in diameter. Cytological preparations were touch imprints of the biopsy fragments obtained under ultrasound guidance. Cytological examination using May-Grunwald Giemsa stain revealed highly cellular smears containing large tumor cells with a round nucleus, prominent nucleoli, and abundant granular basophilic cytoplasm. Cytological features were those of fibrolamellar hepatocellular carcinoma, confirmed by histological examination of the biopsy sample as well as the surgical specimen obtained after wide excision of the lesion following ineffective neoadjuvant chemotherapy.- - - - - - - - - - ranking = 8.425625keywords = physical examination, physical (Clic here for more details about this article) |
8/18. A case of cerebral gigantism and hepatocarcinoma.A 14-year-old boy, who had the physical and neurological characteristics of cerebral gigantism (sotos syndrome), developed hepatocarcinoma. This tumor is rare in children and has never, to our knowledge, been recorded in a patient with cerebral gigantism. An autopsy was performed, the first we are aware of in a patient with cerebral gigantism without increased size in ventricles.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/18. Liver tumours associated with oral contraceptives.Five young women have been encountered with unusual forms of hepatic neoplasms in a ten year period. Each had been taking an oral contraceptive. Two of the four women with benign lesions noted the presence of their tumours, and another woman presented with abdominal pain. Each of these tumours was resected successfully. The fourth patient had the diagnosis made at laparotomy following the development of haemoperitoneum after an attempt at percutaneous liver biopsy. A fifth patient developed jaundice and investigation revealed a hepatocellular carcinoma which was invading the biliary tree. This experience illustrates the need for periodic physical examination of young women who are taking oral contraceptives.- - - - - - - - - - ranking = 8.425625keywords = physical examination, physical (Clic here for more details about this article) |
10/18. Acute polyhydramnios associated with fetal hepatoblastoma.A 28-yr-old gravida II mother presented at 29 wk gestation with acute polyhydramnios. The most common causes for polyhydramnios were excluded and onset of preterm labor at 31 wk prevented further studies. tocolysis failed and a severely asphyxiated boy was born. He had a very distended abdomen with a 7 cm hepatomegaly and was in shock. No other physical abnormalities were found. The child died 15 min after birth. At post mortem examination a fetal type hepatoblastoma was detected. duodenal obstruction due to the liver tumor might have caused the polyhydramnios.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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