Definition:
Hepatocellular carcinoma (HCC) is a primary malignant tumor of the liver, typically originating in hepatocytes. It can also be classified into hepatocellular or cholangiocellular types, with hepatocellular carcinoma being more common. It can also be primary or metastatic, with the latter being frequently associated with adenocarcinoma from abdominal organs.
Classification:
- Primary HCC: Originates from hepatocytes, the liver's main cells.
- Metastatic HCC: Often arises from adenocarcinoma originating in abdominal organs such as the colon, stomach, or pancreas.
Key Features:
- Can present as single or multiple nodules.
- Metastasis is common through the hepatic or portal vein, with spread to lymph nodes, bones, and lungs.
Etiology:
Predisposing factors include:
- Chronic Hepatitis B and C infections.
- Liver Cirrhosis (increases risk significantly).
- Wilson's Disease and Hemochromatosis (iron and copper metabolism disorders).
- Hormonal Drugs (oral contraceptives or treatments for prostate hyperplasia).
Pathogenesis:
- Chronic liver damage (e.g., cirrhosis or viral infections) leads to fibrosis and hepatocyte regeneration.
- Genetic mutations and epigenetic changes accumulate in these regenerating cells, which leads to the development of neoplastic transformation.
Liver Cirrhosis increases the risk of HCC through mechanisms of inflammation, cell turnover, and the induction of pro-oncogenic factors.