Diagnosis and Treatment of Hepatocellular Carcinoma

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (22 November 2023) | Viewed by 1410

Special Issue Editors


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Guest Editor
Academic Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, "Laiko" General Hospital, 17 Agiou Thoma Street, 11527 Athens, Greece
Interests: hepatocellular carcinoma; cirrhosis; portal hypertension; elastography; liver fibrosis

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Guest Editor
1st Department of Internal Medicine, General Hospital of Athens “Laiko”, Medical School of National and Kapodistrian University of Athens, 11527 Athens, Greece
Interests: non alcoholic liver disease; liver transplantation; cirrhosis; viral hepatitis; liver diseases; hepatitis
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Guest Editor
2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Athens, Greece
Interests: surgical oncology; minimally invasive surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hepatocellular carcinoma (HCC) is the most common liver cancer and represents the fourth most common cause of death from cancer worldwide. Chronic infection due to hepatitis B or C virus is the main risk factor, but the role of non-alcoholic fatty liver disease is emerging, particularly in Western countries, where the prevalence of obesity increases. The diagnosis of HCC is usually based on non-invasive imaging criteria, although the need for liver biopsy is revaluated as cancer’s molecular and biological characteristics seem to affect the response to treatment. Liver transplantation, surgical resection, and loco-regional therapies, such as ablation and trans-arterial chemoembolization (TACE), constitute the major treatment options for HCC, considering patients’ performance status, liver function, and the extension of a tumor. The subsequent approval of systematic therapies, including tyrosine kinase inhibitors (TKIs), immune checkpoint inhibitors (ICIs), and monoclonal antibodies, changed the landscape of HCC management. Hence, the induction of these factors not only improved the prognosis of patients previously not eligible for treatment, but is expected to impact the already-established therapeutic strategies. Nevertheless, the optimal sequence and possible combinations of these regimens remain to be defined, while new biomarkers predicting the response to treatment need to be validated. In this Special Issue, we present an update regarding the diagnosis of HCC, the role of biomarkers and liquid biopsy in the evaluation of the disease, and the latest data concerning the current and feature treatment options. 

Dr. Dimitrios Karagiannakis
Dr. Evangelos Cholongitas
Dr. Nikolaos Machairas
Guest Editors

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Keywords

  • hepatocellular carcinoma
  • liver cirrhosis
  • surgical resection
  • loco-regional treatments
  • liver transplantation
  • tyrosine kinase inhibitors
  • immunotherapy

Published Papers (1 paper)

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7 pages, 4512 KiB  
Case Report
A Rare Case of Isolated Hepatocellular Carcinoma Metastasis in Left Mandibular Region in a Patient with Hepatitis C Virus Liver Cirrhosis Diagnosed after the Onset of COVID-19 Infection
by Dragan Mašulović, Aleksa Igić, Aleksandar Filipović, Miloš Zakošek, Dušan Bulatović, Ksenija Mijović, Marjan Micev and Danijel Galun
Medicina 2023, 59(11), 1992; https://doi.org/10.3390/medicina59111992 - 13 Nov 2023
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Abstract
Background and Objectives: Hepatocellular carcinoma (HCC) most frequently metastasizes in the lungs, abdominal lymph nodes and adrenal glands. Metastatic spread to the head and neck area is extremely rare. In the presented case, an uncommon site of solitary metastatic spread of HCC to [...] Read more.
Background and Objectives: Hepatocellular carcinoma (HCC) most frequently metastasizes in the lungs, abdominal lymph nodes and adrenal glands. Metastatic spread to the head and neck area is extremely rare. In the presented case, an uncommon site of solitary metastatic spread of HCC to the mandible confirmed after the core biopsy of the lesion is reported. There have been only about 80 cases of mandibular HCC metastases described in the literature to date. We contribute our experience to the pool of data. Case presentation: A 65-year-old female with HCV-related liver cirrhosis was diagnosed with an HCC that was successfully treated with liver resection. Subsequently, the patient had developed COVID-19 disease, which was associated with a painless swelling in the left jaw. A neck MDCT scan demonstrated an osteolytic soft-tissue mass in the left mandible, with the characteristics consistent for the metastasis of HCC. In order to confirm the diagnosis, a core biopsy of the mandibular mass was performed. The pathohistological evaluation confirmed the presence of a metastatic HCC in the mandible. No other sites of disease dissemination were identified in extensive MDCT scans. Despite considering various treatments, including symptomatic and palliative, the patient’s overall prognosis remained poor. Conclusions: Isolated metastases of HCC to the orofacial region are extremely rare; however, it should be considered in patients with known risk factors for HCC development. Early diagnosis is critical, and clinicians should consider this possibility of HCC spread when assessing patients with orofacial swelling, among those patients with risk factors for HCC. The overall prognosis for such patients remains poor, emphasizing the challenges in managing these cases. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Hepatocellular Carcinoma)
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