HCC with Thrombosis/Occlusion

Liver cancer can be a life-altering experience and can trigger an array of emotions. Taking the time to research the disease and available treatment options will ensure that you receive the most up-to-date information and bestpossible care.

Liver cancer is the fifth 'most-common' cancer in men and the ninth-mostcommon cancer in women.21 If the cancer originates in the liver, it is referred to as ‘primary’ liver cancer. If the cancer has metastasized (spread) to the liver from elsewhere in the body, it is referred to as ‘secondary’ liver cancer. HCC is the most common form of primary liver cancer, and accounts for 5.6% of all cancers.22,23 Many patients with HCC develop portal vein thrombosis (PVT), a blockage or narrowing of the portal vein due to blood clotting. 12 This section will discuss the function and structure of the liver, risk factors for HCC, how it is diagnosed, and where to obtain more information about available treatment options.

Description and Location of the Liver

The liver is the largest internal organ and is located under your ribs. The liver receives its blood supply from two sources: the hepatic artery (25%) which delivers oxygen-rich blood, and the portal vein (75%) which supplies nutrient-rich blood from the intestinal tract.22,27

Role of the Liver

The liver has many important functions, such as:

  • Production of many vital substances required by the body including:22,28,29,30
    • Cholesterol
    • Bile
    • Nucleic acids (DNA [deoxyribonucleic acid] and RNA [ribonucleic acid])
    • Proteins
  • Metabolism of carbohydrates28,29,31
  • Metabolism of proteins28,29,31
  • Storage of vitamins and minerals29
  • Filtration and breakdown of toxic waste in the blood22,29 

Risk Factors for HCC

  • Cirrhosis23
  • Long-term use of anabolic steroids33
  • Smoking32
  • Diabetes32
  • Family history of HCC32 

How HCC Develops and Spreads

The liver is comprised mainly of cells called hepatocytes.22 Normally, these cells grow and divide to replace old or damaged cells. HCC occurs when there is an error in the regulation of liver cell growth, resulting in uncontrolled cell division and the formation of tumors. These tumors can create their own blood vessels to promote further growth; if not detected or contained, cancerous cells are likely to invade these vessels and metastasize (spread) to other parts of the liver or elsewhere in the body. 22,34

Signs and Symptoms of HCC

  • Unexplained weight loss (over 10% of normal body weight)22,35
  • Loss of appetite22,35
  • Abdominal swelling/bloating22,35
  • Abdominal pain22
  • Jaundice22,35
  • Nausea and/or vomiting22
  • Fever35
  • Weakness and/or fatigue36
  • Sudden worsening of health in someone with a liver condition (e.g., cirrhosis, hepatitis C)35

Testing for HCC

When patients show symptoms of HCC, doctors look to the following areas to aid in evaluating the possibility of the disease:

  • Medical history and physical examination22,37
  • Ultrasound scan22,37
  • Blood tests22,37

If results from the above are inconclusive, more thorough scans will be performed using other imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI), which provide more detailed images of the liver and any tumors that may be present.22 If subsequent imaging techniques do not give a clear result, a biopsy may be required to determine if HCC is present.22