Incidence	- one of the ten most common cancers worldwide
Age	- < 50 years
Sex	- M > F
Geography	- uncommon in the West; common in parts of the world where viral hepatitis is endemic
Aetiology	- there is a very high risk of HCC in chronic carriers of HBV and HCV - in areas where HBV is prevalent, 90% of patients with HCC are positive for HBV; cirrhosis is present in 80% of these patients - integration of viral genome into host hepatocytes - also associated with other causes of cirrhosis, e.g. alcoholic cirrhosis, hereditary haemochromatosis - aflatoxin - androgenic steroids - ? OCP
Presentation	History - (rapid onset in a cirrhotic patient of:) - weight loss and anorexia - fever - ache in R hypochondrium Examination - ascites - enlarged, irregular, tender liver
Investigations	Serum a-fetoprotein USS Liver biopsy under ultrasound guidance
Macro	- single tumour or multiple nodules
Micro	- cells resembling hepatocytes
Staging	- metastasizes via portal veins to lymph nodes, bones, lung
Serum markers	- sarum AFP
Management	Surgical - surgical resection may be possible - small tumours in patients with cirrhosis do not always prevent transplantation - chemotherapy and radiotherapy are unhelpful Prevention - vaccination for HBV
Prognosis	- survival is generally 6 months or less
Complications

Hepatobiliary medicine

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