How does hepatocellular carcinoma cause hypoglycemia?
Hypoglycemia in HCC is caused by impaired gluconeogenesis due to a decompensated liver (glucose underproduction) or by a high big IGF-II level produced by tumors, which results in stimulation of the insulin receptors and increased glucose utilization.
What conditions are commonly associated with hepatocellular carcinoma?
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Hepatocellular carcinoma occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection.
What are the common causes of death of patients with HCC?
Background: Most cases of HCC are associated to liver cirrhosis. Tumor extension and liver failure may be competing causes of death in these patients.
Can liver tumors cause hypoglycemia?
Hypoglycemia has been reported to occur in 4–27% of patients with hepatocellular carcinoma (HCC), and is associated with an unfavorable prognosis and poor survival (1).
How does liver disease cause hypoglycemia?
The liver is key to glucose homeostasis. Any disruption of its metabolism, structural integrity, or intracellular dynamics may alter the liver’s ability to maintain normal glucose homeostasis. When such disruption affects hepatic glucose output, hypoglycemia may eventuate.
What is end stage HCC?
Patients with end stage or terminal HCC are those presenting with tumors leading to a very poor Performance Status (ECOG 3-4) or Child-Pugh C patients with tumors beyond the transplantation threshold. Among HCC patients, 15-20% present with end stage or terminal stage HCC. Their median survival is less than 3-4 months.
How fast does HCC spread?
Question 5: how fast do tumors grow? The mean volume doubling time of small (,5 cm) HCCs ranges from 112 to 204 days; the interindividual variability of tumor growth is also very high, the individual doubling time ranging from 30 to 600 days (34–38).
Is dying from HCC painful?
Hepatocellular carcinoma (HCC) remains the most common primary liver malignancy. Pain comprises one of the most pervasive and troubling symptoms of HCC and may have severely negative effects on patient’s quality of life.
What are the clinical signs of liver metastases?
Approximately 50% of the patients with liver metastases have clinical signs of hepatomegaly or ascites; liver function tests tend to be insensitive and nonspecific. Several factors influence the incidence and pattern of liver metastases.
Is it possible to have multiple liver metastases?
Most liver metastases are multiple. In 77% of patients with liver metastases, both lobes are involved; in only 10% of cases is metastasis solitary. Multiple tumors often vary in size; this fact suggests that tumor seeding occurs in episodes.
What kind of radiography is used for liver metastases?
Plain chest radiographs are routinely obtained in patients who are suspected of having cancer and are also used in the staging of cancer, but plain abdominal radiography has a limited role in the investigation of liver metastases. Ultrasonography (US) is widely used in the investigation of suspected liver metastases.
Why is the liver a fertile soil for metastases?
The liver provides a fertile soil in which metastases may become established, not only because of its rich, dual blood supply but also because of humoral factors that promote cell growth. (The blood supply of the liver is exceeded only by that of the lung, in terms of blood flow per minute.)