Liver Cancer

Etiology

  • Cirrhosis for any reason (typically the result of chronic hepatic inflammation x many years)
  • Can also be mets to liver (ie not a primary liver cancer)

Risk Factors

  • Chronic alcoholic hepatitis
  • Chronic hepatitis B, C
  • Fatty liver-->NASH
  • Hemochromatosis, Wilson's disease, other uncommon genetic disorders
  • Sometimes from multiple contributors (e.g. ETOH + Hep C)

Symptoms

  • Anorexia
  • Weight loss
  • Fever, sweats
  • RUQ/epigastric persistent/progressive discomfort
  • May have symptoms related to cirrhosis, including: fatigue, jaundice, loss of muscle mass, development of ascites, peripheral edema, confusion (with encephalopathy), vomiting blood (with varices), darkening of urine

Physical Exam Findings

  • Palpable, firm liver if advanced
  • If decompensated cirrhosis can have combinations of the following: confusion, jaundice, icterus, ascites, lower extremity edema, gynecomastia, spider angiomata, small testes (men), asterixsis

Tests