Clinical symptoms and case classification of liver cancer

Primary liver cancer pathological classification mainly includes the following:

  1. Hepatocellular Carcinoma: Hepatocellular carcinoma is the most common pathological type of primary liver cancer, accounting for about 80%. It originates from liver cells and the cancer cells are arranged in polygonal nests or cord-like structures. According to the gross morphology, hepatocellular carcinoma can be divided into diffuse type, massive type, and nodular type.
  2. Cholangiocarcinoma: This type accounts for 5% to 30% of primary liver cancer and originates from small bile ducts within the liver. Gross morphology can be divided into massive type, nodular type, and diffuse type. It generally does not accompany liver cirrhosis.
  3. Mixed Hepatocellular Carcinoma: Mixed hepatocellular carcinoma contains both hepatocellular carcinoma and cholangiocarcinoma.
  4. Other Rare Types: Including some rare types of primary liver cancer, such as fibrosarcoma, liposarcoma, etc.
    It should be noted that the pathological classification of primary liver cancer is mainly based on the gross morphology, histological features, and clinical manifestations of the tumor. Understanding the pathological classification of hepatocellular carcinoma helps guide clinical diagnosis, treatment, and prognostic assessment.

Here are the clinical symptoms of liver cancer:

Clinical symptoms and case classification of liver cancer
Clinical symptoms and case classification of liver cancer

In the early stage of liver cancer, there may be no symptoms or signs for a long time. The main symptoms and signs of liver cancer include:

  1. Upper abdominal liver pain: This is often intermittent or persistent right upper abdominal pain, which may be dull, sore, or stabbing. If the tumor is located at the top or surface of the liver, it may cause respiratory pain and radiation to the shoulder and back. If the tumor is located in the deep part of the liver, it usually does not cause pain. Liver pain is often related to coughing and position changes, and it often worsens at night. Severe abdominal pain and hypotension shock may occur when liver cancer spontaneously ruptures.
  2. Loss of appetite, abdominal distension, nausea, vomiting, and diarrhea: Loss of appetite and abdominal distension are common, and they may be caused by liver damage leading to digestive disorders or tumor compression of the stomach. Abdominal distension is often caused by gas in the gastrointestinal tract, large tumors in the liver, and ascites.
  3. Hepatomegaly: Most patients with liver cancer have hepatomegaly. The liver may be enlarged significantly, even exceeding the umbilicus, and the surface is often nodular or bulky. The texture is hard, irregular, and tender. If the tumor is located in the deep part of the liver and there is no liver cirrhosis, the surface of the mass is usually smooth. In individual cases, tumor necrosis, liquefaction, or subcapsular hemorrhage may occur, causing the mass to be soft or have a cystic sensation.
  4. Malnutrition, fatigue, fever, etc.: The fever is usually low, and occasionally high fever or chills may occur.
  5. Jaundice, skin and eye yellowing.
  6. Abdominal distension, ascites, lower extremity edema, skin hemorrhage, and epistaxis, gingival bleeding.
  7. Spider-like vascular expansion on the skin.
  8. Clinical manifestations of liver cancer syndrome:
    • Hypoglycemia, occurring in about 10% to 30% of liver cancer patients, which is unrelated to tumor size or location. It may be related to liver dysfunction or tumor cells secreting insulin-like active substances.
    • Polycythemia, occurring in about 10% of liver cancer patients, possibly related to tumor cells producing erythropoietin. Other less common manifestations include hypercalcemia, hyperlipidemia, etc.

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