Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is a primary hepatocyte cancer usually arising in cirrhosis or chronic hepatitis B; early detection and treatment must account for both tumour burden and the reserve of the underlying liver.
Definition
Hepatocellular carcinoma is a primary malignant tumour of hepatocytes. It occurs mainly in cirrhosis or chronic hepatitis B, is often detected through surveillance, and may be diagnosed non-invasively by characteristic multiphasic imaging in an appropriate at-risk liver.
First principles
Chronic injury creates a carcinogenic field
Repeated hepatocyte injury, inflammation and regeneration promote dysplastic nodules and malignant transformation. Cirrhosis is the dominant risk state, but chronic hepatitis B can cause HCC without cirrhosis, so risk-based surveillance is not identical for every aetiology.
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