Cases Of Primary Hepatic Carcinoma Research Articles

Elevated procalcitonin levels in primary hepatic neuroendocrine carcinoma

Rationale:Procalcitonin (PCT) has been identified as a tumor biomarker in medullary thyroid carcinoma. Other neuroendocrine carcinomas with elevated PCT levels are relatively rare, and are mainly reported in the lung, digestive tract, and pancreas. No studies in the literature have reported a case of primary hepatic carcinoma complicated with unexpectedly elevated PCT levels.Patient concerns:A 78-year-old man with persistent fatigue and mild fever was complicated with an extremely high PCT level. Radiological examination revealed a single hypodense lesion in the left lobe of the liver with a “rapid enhancement and rapid washout” pattern. Pathological analysis showed a poorly differentiated neuroendocrine carcinoma (grade 3) with multiple genetic mutations.Diagnosis:Primary hepatic neuroendocrine carcinoma.Interventions:The patient received antibiotic therapy and subsequent transcatheter hepatic arterial chemoembolization; a PCT assessment and computed tomography were performed during the follow-up.Outcomes:The PCT level did not decline after antibiotic therapy but greatly declined in response to effective transcatheter hepatic arterial chemoembolization. The patient survived and is still being followed up.Lessons:An extremely elevated PCT level may raise a suspicion of a neuroendocrine carcinoma and plays an indicative role as a biomarker during therapy.

Exploration on laparoscopic hepatectomy on central liver tumor: a report of 40 cases

Objective: To assess the safety and feasibility of the application of the laparoscopic modality in the perioperative treatment of central liver tumors. Methods: Collecting all the clinical information of a total of 40 patients with central liver tumors who received laparoscopic resection treatment carried out at Department of Hepatological Surgery of People's Hospital of Hunan Provincial from January 2016 to December 2018 to take a retrospective review. There were 19 males and 21 females.The age was (59.5±14.5) years (range: 15 to 71 years) . There were 26 cases of primary hepatic carcinoma (24 cases of hepatocellular carcinoma, 2 cases of cholangiocellular carcinoma) , 8 cases of hepatic cavernous hemangioma, 1 case of metastatic hepatic carcinoma, 5 cases of hepatocellular adenoma. The maximum diameter of tumors were (6.2±2.9) cm (range: 2 to 13 cm) . The patient's information about hepatectomy methods, blocking mode and time of blood flow, operation time, intraoperative blood loss, intraoperative blood transfusion rate, post-operative hospitalization time, perioperative reoperation and postoperative complications were collected. Results: A total of 40 patients all were treated with laparoscopic surgery. The surgical procedure was as follows: 2 patients received the right hepatic lobectomy (Ⅴ, Ⅵ, Ⅶ and Ⅷ segments) , 2 patients received the left hepatic lobectomy (Ⅱ, III and Ⅳ segments) , 13 patients received mesohepatectomy (Ⅳ, Ⅰ and Ⅷ segments) , 2 patients received left hepatic trisegmentectomy (Ⅱ, Ⅲ, Ⅳ and Ⅷ segments) , 2 patients received right hepatic trisegmentectomy (Ⅳ, Ⅴ, Ⅵ, Ⅶ and Ⅷ segments) , 7 patients received Ⅷ segmentectomy, 1 patient received Ⅳ segmentectomy, 3 patients received Ⅴ and Ⅷ segmentectomy, 5 patients received hepatic caudate lobe resection (Ⅰ, Ⅸ segments) , and 3 patients received local tumors resection.Pathological results: there were 26 cases of primary hepatic carcinoma (24 cases of hepatocellular carcinoma, 2 cases of cholangiocellular carcinoma) , 8 cases of hepatic cavernous hemangioma, 1 case of metastatic hepatic carcinoma, 5 cases of hepatocellular adenoma; the pathological reports of all malignant tumor cases all showed negative incisal edge. The operative time was (333±30) minutes (range: 280 to 380 minutes) ; the intraoperative hepatic portal occlusion period was (58±13) minutes (range: 30 to 90 minutes) ; the intraoperative hemorrhage was (173±129) ml (range: 20 to 600 ml) ; the intraoperative blood transfusion rate was 2.5% (1/40) ; the postoperative incidence of bile leakage was 2.5% (1/40) , the hospital discharge of 1 patient with bile leakage was approved after conservative treatments like T pipe decompression and adequate drainage; there was 1 case of abdominal infection and 1 case of pulmonary infection, both of which were discharged from the hospital with conservative treatments; there were no other serious postoperative complications. The postoperative hospital stay was (10.7±2.7) days (range: 6 to 16 days) ; there were no perioperative mortality and reoperation cases. Conclusion: In the centers with abundant laparoscopic hepatectomy experiences, the laparoscopic resection is proved to be safe and feasible in the perioperative treatments of central liver tumors by the highly selective cases, the adequate preoperative assessment and reasonable surgical techniques and approach.

The Incidental Finding of Hepatocellular Carcinoma by Echocardiography

Hepatocellular carcinoma (HCC) is the most common type of primary hepatic malignancy. Most cases of primary hepatic carcinoma are secondary to either viral hepatitis infections (hepatitis C or hepatitis B) or cirrhosis, with chronic alcohol abuse being the most common cause of hepatic cirrhosis. Echocardiography is done primarily to evaluate the overall function of the heart; the condition of the heart muscle, heart valves, and chamber sizes; and the risk for heart disease. It is also used to evaluate the effectiveness of medical or surgical treatment over time. The case presented emphasizes the importance of performing a complete echocardiographic protocol on each patient and being aware of the surrounding structures that might be seen at the periphery of standard images. During an echocardiographic examination, diseases other than heart disease may be found incidentally and should be reported to the referring physician to optimally manage the patient’s care.

Percutaneous Biliary Stent Placement in Palliation of Malignant Bile Duct Obstruction.

BackgroundTo summarize the experiences with the technique of percutaneous biliary stent placement for treatment of malignant biliary obstruction in patients with different types of biliary obstruction.MethodsPercutaneous biliary stent placement was performed in 126 patients with malignant biliary obstruction. The etiology included 56 cases of cholangiocarcinoma, 28 cases of pancreatic cancer, 12 cases of ampullary carcinoma, 10 cases of primary hepatic carcinoma, 8 cases of gastric cancer metastasis, 6 cases of gallbladder carcinoma, and 6 cases of liver metastasis of colon cancer. The obstructed lesion predominantly involved the common bile duct in 42 patients, common hepatic duct in 39 patients, and hilar bile duct in 45 patients. When the bile duct was punctured successfully under fluoroscopy, the guide wire was explored to across the obstruction segment under the assistant of catheter, then the stent was inserted along the super-slippery guide wire. In patients with hilar hepatic duct lesions involving both left and right hepatic ducts, the both ducts were punctured and bilateral stenting was performed. A 8.5 F internal/external drainage catheter was inserted. The liver function test and ultrasound were performed one week after the procedure to observe the decrease of bilirubin and alleviation of biliary obstruction.ResultsA total of 166 stents were implanted in 126 patients. In the 42 patients with common bile duct obstruction, each patient was implanted one stent. In the 39 patients with common hepatic duct obstruction, each patient was impanted one stent. In the 45 patients with hilur bile duct obstruction, 38 patients were placed 2 stents, one patient was placed with 3 stents, and the rest were placed with one stent. The serum total bilirubin decreased from 309.2 ± 158.3 µmol/L before the procedure to148.5 ± 98.0 µmol/L one week after the procedure (P < 0.001). Alkaline phosphatase and alanine aminotransferase significantly decreased (P < 0.001). Five cases died within 1 month (4%) after the procedure. Complications occurred in 9 cases (7.1%). Six patients underwent combined duodenal self-expandable metal stent placement successfully.ConclusionsThe percutaneous biliary stent placement is a safe and effective palliative therapy for malignant biliary obstruction by improving liver function and 1ife quality.

Hepatic adenocarcinoma expressing inhibin in a young patient on oral contraceptives

A case of primary hepatic carcinoma is reported, which occurred in a 24-year-old woman with a 10-year history of oral contraceptive use, and demonstrated unique morphologic and immunohistochemical features. The tumor was located in the left hepatic lobe, measured 14 cm at its widest, and showed histologic heterogeneity. The neoplastic cells were mostly arranged in trabecular and pseudoglandular growth patterns simulating hepatocellular carcinoma; however, in focal areas, small cystic, organoid and tubular patterns predominated. Immunohistochemical stains showed a phenotype consistent with biliary differentiation (positive staining for cytokeratin 7, cytokeratin 19, carcinoembryonic antigen and CA 19-9 antigen). The tumor cells were negative for markers that would be suggestive of hepatocytic or neuroendocrine differentiation. Interestingly, they were positive for inhibin, a protein that is known to be expressed in sex cord-stromal tumors of the ovary, trophoblastic neoplasms and adrenal cortical tumors, but not in hepatic tumors. However, no definite evidence of gonadal stromal, trophoblastic, or adrenocortical differentiation was identified on extensive immunohistochemical work-up. In conclusion, this unique case may represent a rare variant of cholangiocarcinoma expressing inhibin.

Unusual liver carcinomas with sarcomatous features: analysis of four cases.

We recently examined the clinicopathological and immunohistochemical features of four cases of primary hepatic carcinoma with sarcomatoid elements. Three of the four patients had associated ordinary hepatocellular carcinoma (HCC) and one had a sarcomatoid carcinoma with no apparent elements of HCC. The presenting symptoms were high fever and hypochondralgia in three patients, and right hypochondralgia without a high fever in one. The preoperative diagnoses were liver abscess in two patients, HCC in one, and cholangioma in one. Preoperative imaging showed necrotic change or abscess formation in the tumors. The sarcomatous elements showed a positive reaction to vimentin in three patients, but the ordinary HCC cells did not. Macroscopically, the tumors appeared as a single nodule with pericapsular growth. The prognoses of these patients were poor due to the early development of intrahepatic or distal metastases. We conclude that symptoms such as a high fever or hypochondralgia are characteristics of these tumors and that they may be histogenetically derived from a dedifferentiation of HCC, although no elements of HCC were found in one of our cases.

Clinical and experimental study on regional administration of phosphorus 32 glass microspheres in treating hepatic carcinoma.

AIM:To study the therapeutical effectiveness, dosage range and toxic adverse effects of domestic phosphorus 32 glass microsphere and evaluate its clinical significance.METHODS:I.Fifty two BALB/c tumor bearing male nude mice were allocated into treatment group(n = 38) and control group(n = 14). In the former group different doses of (32) P-GMS were injected into the tumor mass, while in the latter (31)P-GMS or no treatment was given. The experimental animals were sacrificed in batches, and then the tumors and their nearby tissues were examined by light and electron microscopy.II. Through selective catheterization of hepatic artery, (32)P-GMS was infused to 5 healthy domestic pigs in a dosage equivalent to the therapeutic dose for human being, and (31)P-GMS was infused to another 5 healthy domestic pigs. Two pigs infused with contrast medium served as whole course blank controls. One pig from each group was surrendered to euthanasia at week 1, 4, 8 and 16 respectively. The ultrastructural histopath ological changes in liver tissues taken from different sites were evaluated semiquan titatively. III. One hundred and twenty seven times of (32)P-GMS intrahepatic artery interventional therapies were performed on 93 patients with hepatic carcinoma, including 79 cases of primary hepatic carcinoma and 14 cases of secondary hepatic carcinoma. (32)P-GMS (n = 30), and group B,(32)P-GMS and half dose of trans hepatic artery embolization (TAE)(n = 49), and 18 patients with HCC by TAE only as control group C. Fourteen patients with secondary hepatic carcinoma were treated in the same way as group B or C.RESULTS:I.Comparing with the control group, the treatment group of tumor bearing nude mice attained the tumor inhibition rates of 59.7%-93.7% (F = 579.62 P < 0.01) at 14d. At an absorbed dose of 7320Gy, the tumor cells were completely destroyed. When the absorbed doses ranged from 1830Gy to 3660Gy, most of the tumor cells showed the evidences of injury or necrosis, but there appeared some well differentiated tumor cells and enhanced effect of the autoimmunocytes. At an absorbed dose of 366Gy or less, some tumor cells still remained active prolix-ferative ability. The definite anticancer effect appeared as early as 3d after intratumoral injection of (32)P-GMS.II. The cumulative amount of (32) P-GMS in the target tissue after trans hepatic artery instillation attained more than 90% of the total dose administrated. Semiquantitative analysis of ultrastructral morphology in the experimental group showed no statistical difference between the nuclear abnormality (N(abn)) and mitochondrial variability (M(var)) at week 1 or 2, but revealed prominent difference (X(2) = 6.70-9.68, P < 0.01, X(2) = 65.09-115.09, P <0.001) as compared with those in the other groups. In the experimental group the N abn in tissues showed no significant difference between week 8 and week 16. No apparent changes were found in the stomach, spleen, kidney and lung tissues of the experimental pigs. III. The therapeutical results of HCC patients in group A were closely approximated to those of group C, no hematological toxic side effects were noted, and the systemic reaction was mild. In some patients 2mos-3mos after treatment some secondary foci appeared around the periphery of the primary lesion. In general better effectiveness was obtained in patients with small lesion. After analyzing by RIDIT method, the therapeutic result in group B was significantly better than that in group C, and secondary foci around the original lesion were rarely seen at 3mos after treatment. In group C the collateral circulation was reestablished along the periphery of primary foci and the secondary foci appeared more frequently, and were required to undergo several courses of treatment. In group B, 4 cases of HCC were treated surgically as their mass decreased in size after (32)P-GMS treatment.Resected specimens showed that the tumor was encapsulated by fibrotic tissue and most of the tumor cells necrosed. The 3 year survival rates were 43.3%-51.0% after A and B regimen treatment. In 14 cases of secondary HCC, the foci were well controled within one year after treatment.CONCLUSION:When the experimental model of implanted human liver cancer cells received (32)P-GMS of 1830Gy-3660Gy, it produced excellent anticancer effect without any injury to the normal neighboring tissues and the prominent anticancer effect was shown within 3d after intratumoral injection. Intrahepatic arterial administration of (32)P-GMS at the macro-cosmic absorbed dosage less than 190 Gy/dose exerted reversible sub lethal injury to domestic pig liver tissues. It took more than 8 weeks to repair the injured liver tissue and restore its function.(32)P-GMS trans hepatic artery embolization is an effective and safe regimen in treating hepatic carcinoma.

Expression of pre-S1 and pre S2 antigens of hepatitis B virus and their significance in human primary hepatic carcinoma

The specimens of 135 cases of primary hepatic carcinoma were obtained from the Pathological Laboratory of the First Affiliated Hospital of the Fourth Military Medical University, Xi’ an, PRC. Ten percent formalin-fixed and paraffin- embedded sections were stained by HE and by ABC and PAP immunohistochemical methods. Positive rates of pre- S1 and pre- S2 antigens in cancerous tissue were 22. 2% and 20. 0%, respectively, while those in surrounding hepatic tissue were 60.6% and 59.6%, separately. The pre- S1 and pre- S2 antigens were found to coexist in 16.3% of cancerous tissue and in 55.6% of surrounding hepatic tissue. In all the 135 cases of hepatic carcinoma, the cancerous tissue showed positive HBsAg in 16.3%, HBxAg in 55. 6% and HBcAg in 8. 9%; in the surrounding hepatic tissue, positive HBsAg was 59.6%, HBxAg 78.8% and HBcAg 24.2%. The results of this study suggestes that positive rates of pre- S1 and pre-S2 antigens in cancerous tissue were slightly higher than that of HBsAg, but markedly lower than that of HBxAg. The positive rate of pre-S1 and pre-S2 antigens in surrounding hepatic tissue was nearly the same as HBsAg, but slightly lower than that of HBxAg. Antigens of pre-S1 and pre-S2are the new markers of HBV infection. The same as other antigens, they may play an important role in the development of hepatic carcinoma. The mechanism of their effect will be further investigated.

The diagnostic value of a hepatoma‐specific band of serum gamma‐glutamyl transferase

Using a vertical slab electrophoretic apparatus loaded with polyacrylamide stage gel plate, we observed a total of II bands of gamma-glutamyl transferase (EC 2.3.2.2,GGT) on a gel plate and designated these GGT I-XI by order of distance beginning at the positive pole. Positive GGT II was found in 81 (90%) of 90 cases of primary hepatic carcinoma (PHC), in 9(90%) of 10 cases of secondary hepatic carcinoma (SHC), and in only 4 (3.1%) of a total of 128 cases of acute and chronic liver disease. There was one case with positive GGT II among 45 cases of cancer of ampulla of Vater, but the possibility of hepatic metastasis could not be excluded. No GGT II was found in a total of 250 healthy persons and 21 pregnant women. PHC patients with negative alpha-fetoprotein (AFP) had a positive GGT II rate of 84.6%, whereas in those with negative GGT II the positive rate for AFP was only 44.4%.

Primary carcinoma of the liver in Mexican adults.

Among 6558 autopsies performed in the General Hospital of Mexico City, only 37 (0.56%) cases of primary hepatic carcinoma were found despite an exceedingly high incidence (13.4%) of cirrhosis. Two thirds of the liver cell carcinoma coexisted with cirrhosis and 0.26% of all cases of cirrhosis were complicated by primary liver carcinoma. This low incidence of hepatic cancer has also been encountered in other Latin American countries. A tendency of liver cell carcinoma to appear predominantly in macronodular types of cirrhosis was documented, and the fact that cirrhosis in Mexico is more often micronodular is suggested as an explanation for the gap in the incidences of cirrhosis and hepatic carcinoma. It is suggested that gross classification of cancer of the liver be based on extension of the tumor within the liver rather than on appearance because of the difficulties in using uniform nomenclature and because of the surgical importance of intrahepatic distribution of the tumor.

Primary liver cell carcinoma associated with biliary cirrhosis due to congenital bile duct atresia: First report of a case

A case of primary hepatic carcinoma superimposed on biliary cirrhosis due to congenital biliary atresia in a 3-year-old patient is reported. The patient presented obstructive jaundice from 3 days of age, signs of biliary cirrhosis and hepatic insufficiency, and malnutrition. Postmortem examination revealed liver cell carcinoma primary in the right lobe of the liver with pulmonary metastasis, advanced biliary cirrhosis, and complete absence of extrahepatic bile ducts. No case of the occurrence of hepatoma in a child with biliary cirrhosis due to biliary atresia has been reported previously.

RADIOISOTOPE SCANNING IN PRIMARY CARCINOMA OF THE LIVER.

Characteristically, primary hepatic carcinoma remains undetected until advanced. This occultness results primarily from an absence of distinctive clinical features and from the inaccessibility of the liver. Concealment is augmented, in all probability, by a low index of clinical suspicion because of the rarity of the neoplasm in this country. The difficulty in establishing the diagnosis of primary carcinoma of the liver is illustrated by the recent report of Patton and Horn, in which 42 of 60 proved cases remained undiagnosed until autopsy (8). Clinical findings that may be associated with primary hepatic carcinoma include painful hepatomegaly, a palpable hepatic mass, jaundice, and portal hypertension with ascites (frequently sanguineous). The stigmata of cirrhosis, particularly the postnecrotic type, may be present although cirrhosis itself is absent in 25 to 60 per cent of the cases (5). Radiographic findings are nonspecific reflections of hepatomegaly and/or portal hypertension if present (3); however, the demonstration of elevation of the right diaphragm and of esophageal varices should suggest the possibility of primary hepatic carcinoma (10). No distinctive pattern of hepatic functional abnormality has been observed. Since 1954, radioisotope scanning of the liver has provided an atraumatic method for effectively visualizing the liver and mass lesions within it. Its clinical usefulness in detecting and following many forms of hepatic disease has been summarized (2, 11), but its application to the diagnosis of primary hepatic carcinoma has received scant attention in the American literature. Accordingly, it was decided to present the results of radioisotope scanning in primary liver carcinoma at the Columbia-Presbyterian Medical Center. Clinical Material and Methods Thirteen cases of primary hepatic carcinoma were encountered in 1,750 radioisotope scans of the liver obtained since 1960. The diagnosis was established by closed or open liver biopsy (6 cases) or autopsy (7 cases.) The patients ranged in age from five months to seventy-one years ; 10 were male. Postnecrotic cirrhosis was present in 3 cases, and nutritional cirrhosis, periportal fibrosis, and “early cirrhosis” in 1 case each. Radioisotope scanning was performed with a modified conventional scanner containing a collimated 3-in. NaI (Th) crystal and pulse discriminator. The radiopharmaceutical administered to each patient was colloidal gold 198 in intravenous dosage of 2.2 microcuries per kilogram of body weight. Scanning was instituted approximately twenty minutes after injection and was completed forty-five to sixty minutes later. Contrast amplification was utilized in all photoscans. Results The liver was satisfactorily outlined in the 13 patients. Concentration of radioactivity in the extrahepatic reticuloendothelial tissue was increased in 6 patients; this finding was absent in 5 and indeterminate in 2.

PRIMARY CARCINOMA OF THE LIVER IN INFANCY AND CHILDHOOD

The clinical and pathologic findings in 11 cases of primary hepatic carcinoma occurring in infancy and childhood are presented from the records of the Mayo Clinic from 1905 through 1958. These tumors are rarely encountered in routine practice. All the children were of Caucasian stock and there was no previous history of hepatic disease in 10 cases. In the remaining case the patient had been treated by radiation therapy for hemangioma of the liver 6 years previous to admission to the Clinic. No common factors of possible etiologic significance were present in these patients. Some of the features of previous reports in this field have been described and they are compared and contrasted with the findings in the 11 cases presented. On histologic grounds such tumors of the liver can be divided into two groups: primary carcinomas and mixed tumors. Of the 11 tumors presented seven were considered to be examples of primary carcinomas and four were mixed tumors. The presence of a sarcomatous-like stroma is considered necessary for the diagnosis of a mixed tumor in the absence of osteoid tissue, cartilage, bone or muscle. It is also contended that the presence of osteoid tissue in any amount precludes the diagnosis of primary carcinoma and necessitates a designation of mixed tumor. All the tumors were considered to be malignant and extrahepatic metastasis is described in seven instances. The tumors proved to be fatal within 2 years from the onset of symptoms in 10 cases. In the remaining case, although the child is alive, multiple pulmonary metastatic lesions are present.

The histogenesis of primary hepatic carcinoma.

The existence of hepatocellular and cholangiocellular carcinomata, arising from liver cells and bile duct epithelium respectively, has long been recognized, although the proportions of each type have varied in different series. Gustafson (1937) reported 39 liver cell and 11 bile duct tumours amongst 62 cases of primary liver carcinoma based on 24,400 necropsies, and Wilbur, Wood, and Willett (1944) described 45 hepatomas and four cholangiomas. This predominance of liver cell tumours is also stressed by Counseller and Mclndoe (1926), Loesch (1939), and Hoyne and Kernohan (1947). On the other hand, Fried (1924) described four cholangiomas and one hepatoma, while Karsner (1911) and Cunningham (1943) reported a preponderance of cholangiomas. The existence of a combined tumour, consisting of hepatocellular and cholangiocellular elements, has been postulated comparatively recently. Milne (1909) and Beattie and Donaldson (1912) only recognized two types, while Pirie (1921) reported five tumours of doubtful or mixed amongst 36 cases of primary hepatic carcinoma. Gustafson (1937) described two cases of intermediate or dual origin in his series and this combined carcinoma has also been described by Warvi (1944). Allen and Lisa (1949), reporting five cases of combined liver cell and bile duct tumours amongst 35 cases of primary hepatic carcinoma, described three possible combinations, namely, separate hepatoand cholangiocellular tumours in the same liver, separate tumours which intermingle, and individual masses which display both features so intimately associated that they can only be interpreted as arising from the same site. Three of their cases fell within the last group, while Campbell (1949) described four examples of mixed tumour amongst 22 cases of spontaneous hepatocellular and cholangiocellular carcinoma in ducks. The occurrence of three apparently mixed hepatoand cholangiocellular tumours in an un-

Case of teratoma of the liver, with fourteen-year postoperative survival

CancerVolume 9, Issue 4 p. 848-850 ArticleFree Access Case of teratoma of the liver, with fourteen-year postoperative survival S. M. Yarbrough M.D., S. M. Yarbrough M.D. Gainesville, Texas, and Long Beach, CaliforniaSearch for more papers by this authorG. Evashwick M.D., G. Evashwick M.D. Gainesville, Texas, and Long Beach, CaliforniaSearch for more papers by this author S. M. Yarbrough M.D., S. M. Yarbrough M.D. Gainesville, Texas, and Long Beach, CaliforniaSearch for more papers by this authorG. Evashwick M.D., G. Evashwick M.D. Gainesville, Texas, and Long Beach, CaliforniaSearch for more papers by this author First published: July/August 1956 https://doi.org/10.1002/1097-0142(195607/08)9:4<848::AID-CNCR2820090434>3.0.CO;2-9Citations: 13AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. References 1 Brunschwig, A.: Report to Texas Medical Association, April, 1955. 2 Lorimer, W. S., Jr.: Right hepatolobectomy for primary mesenchymoma of the liver. Ann. Surg. 141: 246– 250, 1955. 3 Milman, D. H., and Grayzel, D. M.: Mixed tumor of the liver; report of a case with a review of the literature. A.M.A. Am. J. Dis. Child. 81: 408– 420, 1951. 4 Overton, R. C.; Kaden, V. G., and Livesay, W. R.: The surgical significance of primary carcinoma of the liver; an analysis of sixty-six cases and a report of an unusual case of primary hepatic carcinoma. Surgery 37: 519– 532, 1955. 5 Pack, G. T.; Miller, T. R., and Brasfield, R. D.: Total right hepatic lobectomy for cancer of the gallbladder; report of three cases. Ann. Surg. 142: 6– 16, 1955. 6 Yarbrough, S. M.: Report of a case of teratoma of the liver in an infant. Texas State J. Med. 40: 426– 427, 1944. Citing Literature Volume9, Issue4July/August 1956Pages 848-850 ReferencesRelatedInformation

The surgical significance of primary carcinoma of the liver; an analysis of sixty-six cases and a report of an unusual case of primary hepatic carcinoma.

The surgical significance of primary carcinoma of the liver; an analysis of sixty-six cases and a report of an unusual case of primary hepatic carcinoma.

Evaluation of hepatic tests and clinical findings in primary hepatic cancer.

The importance of primary hepatic cancer has been stressed in recent reports in the literature. At the United States Public Health Service Hospital, Staten Island, N. Y., we have had the opportunity to study 19 proved cases of primary hepatic carcinoma, with special emphasis on the detailed analysis of hepatic tests as well as the pertinent clinical features. It is well known that primary hepatic cancer is a rare disease in European and North American populations. In Europe, this entity is seen in 0.13% of all autopsies and comprises 1.1% of all carcinomas, and in America, it is seen in 0.25% of all autopsies and comprises 2.1% of all carcinomas, while in the Orient it is seen in 0.85% of all autopsies and comprises 14.1% of all carcinomas. The incidence of hepatic cancer at this institution is unusually high in comparison to that for Europe and North America. This disease