Skip to main content
SpringerLink
Log in

Clinical Manifestations and Paraneoplastic Syndromes of Hepatocellular Carcinoma

  • Chapter
Neoplasms of the Liver

Abstract

Hepatocellular carcinoma presents clinically in many diverse ways. The variety of the presenta-tions stems partly from the different biological characteristics of hepatocellular carcinoma in high- and low-incidence regions and partly from the wide range of paraneoplastic phenomena which may precede the local manifestations of the tumor.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Purves LR (1967) Alpha-fetoprotein and the diagnosis of liver cell cancer. In: Cameron HM, Linsell CA, Warwick GP (eds) Liver cell cancer. Elsevier, Amsterdam, pp 61–80

    Google Scholar 

  2. Chlebowski RT, Tong M, Weissman J, Block JB, Ramming KP, Weiner JM, Bateman JR, Chlebowski J (1984) Hepatocellular carcinoma. Diagnostic and prognostic features in North American patients. Cancer 53:2701–2706

    Article  PubMed  CAS  Google Scholar 

  3. Kew MC, Dos Santos HA, Sherlock S (1971) Diagnosis of primary cancer of the liver. Br Med J 4:408–411

    Article  PubMed  CAS  Google Scholar 

  4. Kew MC, Geddes EW (1982) Hepatocellular carcinoma in rural southern African Blacks. Medicine 61:98–108

    Article  PubMed  CAS  Google Scholar 

  5. Alpert ME, Hutt MSR, Davidson CS (1969) Primary hepatoma in Uganda. Am J Med 46:794–802

    Article  PubMed  CAS  Google Scholar 

  6. Epstein S (1964) Primary carcinoma of the liver. Am J Med Sci 48:137–143

    Article  Google Scholar 

  7. Lai CL, Lam KC, Wong KP, Wu PC, Todd D (1981) Clinical features of hepatocellular carcinoma: Review of 211 patients in Hong Kong. Cancer 47:2746–2755

    Article  PubMed  CAS  Google Scholar 

  8. Melia WM, Wilkinson ML, Portmann BC, Johnson PJ, Williams R (1984) Hepatocellular carcinoma in the non-cirrhotic liver: A comparison with that complicating cirrhosis. Quart J Med 53:391–400

    PubMed  CAS  Google Scholar 

  9. Craig JR, Peters RL, Edmondson HA, Omata M (1980) Fibrolamellar carcinoma of the liver: A tumor of adolescents and young adults with distinctive clinicopathologic features. Cancer 46: 372–379

    Article  PubMed  CAS  Google Scholar 

  10. Tang Z-Y (1985) Subclinical hepatocellular carcinoma. China Academic Publishers, Beijing

    Google Scholar 

  11. Gelfand M, Castle WM, Buchanan WM (1972) Primary carcinoma of the liver (hepatoma) in Rhodesia. S Afr Med J 46:527–532

    PubMed  CAS  Google Scholar 

  12. Sung JL, Wang TH, Yu JY (1976) Clinical study of primary carcinoma of the liver in Taiwan. Am J Dig Dis 12:1036–1049

    Article  Google Scholar 

  13. Okuda K (1976) Clinical aspects of hepatocellular carcinoma—analysis of 134 cases. In: Okuda K, Peters RL (eds) Hepatocellular carcinoma. Wiley, New York, pp 387–436

    Google Scholar 

  14. Ihde DC, Sherlock P, Winawer SJ, Fortner JG (1974) Clinical manifestations of hepatoma. Am J Med 56:83–91

    Article  PubMed  CAS  Google Scholar 

  15. Luna G, Florence L, Johansen K (1985) Hepatocellular carcinoma. A 5 year institutional experience. Am J Surg 149: 591–594

    Article  PubMed  CAS  Google Scholar 

  16. El-Domeiri AA, Huvos AG, Goldsmith HS, Foote FW (1971) Primary malignant tumors of the liver. Cancer 27:7–11

    Article  PubMed  CAS  Google Scholar 

  17. Kew MC, Paterson AC (1985) Unusual clinical presentations of hepatocellular carcinoma. Trop Gastroenterol 6:10–22

    PubMed  CAS  Google Scholar 

  18. Kojiro M, Kawabata K, Kawano Y, Shirai F, Takemoto N, Nakashima T (1982) Hepatocellular carcinoma presenting as intra-bile duct tumor growth. Cancer 48:2144–2147

    Article  Google Scholar 

  19. Roslyn JJ, Kuchenbecker S, Longmire WP, Thompkins RK (1984) Floating tumor debris. A cause of intermittent biliary obstruction. Arch Surg 119:1312–1315

    Article  PubMed  CAS  Google Scholar 

  20. Brand SN, Brand LJ, Sprayregan S, Brenner S, Bernstein LH (1976) Extra-hepatic biliary tract obstruction secondary to a hepatoma-containing blood clot in the common bile duct. Dig Dis 21:905–909

    Article  CAS  Google Scholar 

  21. Chearanai O, Plengvanit U, Asavanich C, Damrongsak D, Sundhvananda K, Boonyapsit S (1983) Spontaneous rupture of primary hepatoma. Cancer 51:1532–1536

    Article  PubMed  CAS  Google Scholar 

  22. Carayon A, Courson B, Virieu R (1967) Compression modulaire par métastase d’un foie cliniquent inapparent. Bull Soc Med Afr Noire Lang Fr 13:586–593

    Google Scholar 

  23. Okazaki H, Yoshimo M, Yoshida T, Hirohashi S, Kishi K, Shimosato Y (1985) Bone metastasis in hepatocellular carcinoma. Cancer 55:1991–1994

    Article  PubMed  CAS  Google Scholar 

  24. Byrne MJ, Scheinberg MA, Mavligit G, Dawkins RL (1972) Hepatocellular carcinoma: presentation with métastases and radicular compression. Cancer 30:202–205

    Article  PubMed  CAS  Google Scholar 

  25. Levy JI, Geddes EW, Kew MC (1976) The chest radiograph in primary liver cancer. S Afr Med J 50:1323–1326

    PubMed  CAS  Google Scholar 

  26. Willett IR, Sutherland RC, O’Rourke MF, Dudley FJ (1984) Pulmonary hypertension complicating hepatocellular carcinoma. Gastroenterology 87:1180–1184

    PubMed  CAS  Google Scholar 

  27. Horie Y, Suou T, Hirayama C, Nagasako N (1982) Spontaneous rupture of the spleen secondary to metastatic hepatocellular carcinoma: A report of a case and review of the literature. Am J Gastroenterol 77:882–884

    PubMed  CAS  Google Scholar 

  28. Stein CM, Gelfand M (1985) Hepatocellular carcinoma presenting as a fever of undetermined origin. Cent Afr J Med 31:21–22

    PubMed  CAS  Google Scholar 

  29. Nakamura T, Nakamura S, Aikawa T (1968) Obstruction of the inferior vena cava in the hepatic portion and hepatic veins. Report of 8 cases and review of the Japanese literature. Angiology 19:479–498

    Article  PubMed  CAS  Google Scholar 

  30. Simson IW (1982) Membranous obstruction of the inferior vena cava and hepatocellular carcinoma in southern Africa. Gastroenterology 82:171–179

    PubMed  CAS  Google Scholar 

  31. Kato R, Tanaka N, Kobayashi K, Ikeda T, Hattori N, Nonamura N (1983) Growth of hepatocellular carcinoma into the right atrium. Ann Intern Med 99:472–474

    Article  PubMed  CAS  Google Scholar 

  32. Dajani YF (1977) Hepatoma causing a massive tumor embolus. Postgrad Med J 53:405–408

    Article  PubMed  CAS  Google Scholar 

  33. Reingold RM, Smith BR (1978) Cutaneous métastases from hepatomas. Arch Dermatol 114:1045–1046

    Article  PubMed  CAS  Google Scholar 

  34. Schwarz KO, Schwartz IJ, Marchervky A (1982) Virchow-Troiier’s lymph node as a presenting sign of hepatocellular carcinoma. Mt Sinai J Med 48: 59–62

    Google Scholar 

  35. Morishita M, Fukuda J (1984) Hepatocellular carcinoma metastatic to the maxillary nasal gingiva. J Oral Maxillofac Surg 42:812–815

    Article  PubMed  CAS  Google Scholar 

  36. Kim SY, Lim JH (1985) Extension of hepatoma to the rectus abdominis muscle via ligamentum teres hepatis. Gastrointest Radiol 10:119–121

    Article  PubMed  CAS  Google Scholar 

  37. Waxman JS, Seife B, Waxman M (1985) Hepatocellular carcinoma presenting as sphenoid sinus metastasis. Mt Sinai J Med 52:221–224

    PubMed  CAS  Google Scholar 

  38. Bith S, Hasgawa H, Ohtsuki H, Obashi J, Kobayashi Y (1985) Parasellar métastases: Four autopsied cases. Surg Neurol 23:41–48

    Article  Google Scholar 

  39. Kew MC, Dusheiko GM (1981) Paraneoplastic manifestations of hepatocellular carcinoma. In: PD Berk, TC Chalmers (eds) Frontiers in liver disease. Thieme-Stratton, New York, pp 305–319

    Google Scholar 

  40. McFadzean AJS, Yeung RTT (1969) Further observations on hypoglycemia in hepatocellular carcinoma. Am J Med 47:220–235

    Article  PubMed  CAS  Google Scholar 

  41. Sasaki K, Okuda S, Takahashi M, Sasaki M (1981) Hepatic clear cell carcinoma associated with hypoglycemia and hypercholesterolemia. Cancer 47:820–822

    Article  PubMed  CAS  Google Scholar 

  42. Ross JS, Kurian S (1985) Clear cell hepatocellular carcinoma: Sudden death from hypoglycemia. Am J Gastroenterol 80:188–194

    PubMed  CAS  Google Scholar 

  43. Wanebo HJ, Schessinger I, Tashima CK (1966) Severe hypoglycemia associated with terminal lymphomas. Cancer 19:1451–1458

    Article  PubMed  CAS  Google Scholar 

  44. Elias AN, Gwinup G (1982) Glucose-resistant hypoglycemia in inanition. Arch Intern Med 142:743–746

    Article  PubMed  CAS  Google Scholar 

  45. Gorden P, Hendricks CM, Kahn CR, Megeyesi K, Ross J (1981) Hypoglycemia associated with non-islet cell tumor and insulin-like growth factors. N Engl J Med 305:1452–1455

    Article  PubMed  CAS  Google Scholar 

  46. Widmer U, Zapf J, Froesch ER, Kew MC (1983) Insulin-like growth factor levels measured by radioimmunoassay and radioreceptor assay in various forms of tumor hypoglycemia. In: Spencer M (ed), Insulin-like growth factors/somatomedins. De Gruyter, Berlin, pp 317–323

    Google Scholar 

  47. Horecker BL, Hiatt HH (1958) Pathways of carbohydrate metabolism in normal and neoplastic cells. N Engl J Med 258:177–184

    Article  PubMed  CAS  Google Scholar 

  48. Landon BR, Wills N, Craig RW, Leonard CR, Moriwaki T (1962) The mechanism of hepatoma induced hypoglycemia. Cancer 15:1188–1196

    Article  Google Scholar 

  49. Okabe T, Urabe A, Kato T, Chiba S, Takaku F (1985) Production of erythropoietin-like activity by human renal and hepatic carcinomas in cell culture. Cancer 55:1918–1923

    Article  PubMed  CAS  Google Scholar 

  50. Fried W (1972) The liver as a source of extra-renal erythropoietin production. Blood 40:671–677

    PubMed  CAS  Google Scholar 

  51. Kew MC, Fisher JW (1986) Serum erythropoietin concentrations in patients with hepatocellular carcinoma. Cancer 58:2485–2488

    Article  PubMed  CAS  Google Scholar 

  52. Jacobson RJ, Lowenthal MN, Kew MC (1978) Erythrocytosis in hepatocellular carcinoma. S Afr Med J 53:658–660

    PubMed  CAS  Google Scholar 

  53. Stevenson JG (1985) Malignant hypercalcemia. Br Med J 291:421–422

    Article  CAS  Google Scholar 

  54. Knill-Jones RP, Buckle RM, Parsons V, Williams R (1970) Hypercalcemia and increased parathyroid hormone activity in primary hepatoma. N Engl J Med 282:704–708

    Article  PubMed  CAS  Google Scholar 

  55. Goldberg RB, Bersohn I, Kew MC (1975) Hypercholesterolemia in primary cancer of the liver. S Afr Med J 49:1464–1466

    PubMed  CAS  Google Scholar 

  56. Harry DS, Morris HP, McIntyre N (1971) Cholesterol biosynthesis in transplantable hepatomas: Evidence for impairment of uptake and storage of dietary cholesterol. J Lipid Res 72:313–317

    Google Scholar 

  57. Brown MS, Dana SE, Siperstein MD (1974) Properties of 3-hydroxy-3-methyl glutaryl co-enzyme A reductase solubilized from rat liver and hepatoma. J Biol Chem 249:6586–6589

    Google Scholar 

  58. Danilewitz MD, Herrerra GA, Kew MC, Mendelsohn D, Barnes S, Alexander CB, Hirschowitz BI, Spenney JG (1984) Autonomous cholesterol biosynthesis in murine hepatoma. A receptor defect with normal coated pits. Cancer 54:1562–1568

    Article  PubMed  CAS  Google Scholar 

  59. Tio TH, Lejinse B, Jarret A, Rimington C (1957) Acquired porphyria from a liver tumor. Clin Sci 16:517–527

    PubMed  CAS  Google Scholar 

  60. Keczkes K, Barker DJ (1976) Malignant hepatoma associated with acquired hepatic cutaneous porphyria. Arch Dermatol 112:78–82

    Article  PubMed  CAS  Google Scholar 

  61. Pierach CA, Bossenmairer IC, Cardinal RA, Weiner MK (1984) Pseudo-porphyria in a patient with hepatocellular carcinoma. Am J Med 76: 545–548

    Article  PubMed  CAS  Google Scholar 

  62. McArthur JW, Toll GD, Russneid AB (1973) Sexual precocity attributable to ectopic gonadotropin secretion by hepatoblastoma. Am J Med 54:390–403

    Article  PubMed  CAS  Google Scholar 

  63. Summerskill WHS, Adson MA (1962) Gynecomastia as a sign of hepatoma. Am J Dig Dis 7:250–254

    Article  PubMed  CAS  Google Scholar 

  64. Kew MC, Kirschner MA, Abrahams GE, Katz M (1977) Mechanism of feminization in primary liver cancer. N Engl J Med 296:1084–1088

    Article  PubMed  CAS  Google Scholar 

  65. Aabo K, Dimitrov NV (1980) Feminization in hepatocellular carcinoma corrected by chemotherapy: A case report. Med Pediat Oncol 8:275–280

    Article  CAS  Google Scholar 

  66. Curth W (1969) Hepatoma. Arch Dermatol 99:374–375

    Article  Google Scholar 

  67. Nusbacher J (1964) Migratory venous thrombosis and cancer. New York J Med 64:2166–2173

    PubMed  CAS  Google Scholar 

  68. Ito M, Tanaka T (1960) Pseudo-ichtyose acquise en taches circulaires. Ann Derm Et Syphil 87: 826–837

    Google Scholar 

  69. DiBisceglie AM, Hodkinson HJ, Berkowitz I, Kew MC (1986) Pityriasis rotunda—a cutaneous sign of hepatocellular carcinoma in southern African Blacks. Arch Dermatol 122:802–804

    Article  PubMed  CAS  Google Scholar 

  70. Primack A, Wilson J, O’Connor GT, Engelman K, Hull E, Cavellos GP (1971) Hepatocellular carcinoma and the carcinoid syndrome. Cancer 27:1182–1189

    Article  PubMed  CAS  Google Scholar 

  71. Morgan AG, Walker WC, Mason MK (1972) A new syndrome associated with hepatocellular carcinoma. Gastroenterology 63:340–345

    PubMed  CAS  Google Scholar 

  72. Sparagnana N, Philips G, Hoffman C, Kucera L (1971) Ectopic growth hormone syndrome associated with lung cancer. Metabolism 20:730–736

    Article  Google Scholar 

  73. Ueno N, Yoshida K, Hirose S, Yokoyama H (1984) Angiotensinogen-producing hepatocellular carcinoma. Hypertension 6:931–933

    Article  PubMed  CAS  Google Scholar 

  74. Calvey HD, Melia WM, Williams R (1983) Polyneuropathy: An unreported non-metastatic complication of hepatocellular carcinoma. Clin Oncol 9:199–202

    PubMed  CAS  Google Scholar 

  75. Helzeberg JH, McPhee MS, Zarling EJ, Lukert BP (1985) Hepatocellular carcinoma: An unusual course with hyperthyroidism and inappropriate thyroid-stimulating hormone production. Gastroenterology 88:181–184

    Article  Google Scholar 

  76. Kalk JW, Kew MC, Danilewitz MD, Jacks F, van der Walt LA, Levin J (1982) Thyroxine-binding globulin and thyroid function tests in patients with hepatocellular carcinoma. Hepatology 2:72–76

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, University of the Wit-watersrand Medical School and Johannesbury and Baragwanath Hosptials, Johannesburg, South Africa

    Michael C. Kew

Authors
  1. Michael C. Kew
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. First Department of Medicine, Chiba University School of Medicine, Inohana, Chiba, 280, Japan

    Kunio Okuda M.D., Ph.D.

  2. Department of Hepatic Pathology, Armed Forces Institute of Pathology, Washington, DC, 20306, USA

    Kamal G. Ishak M.D., Ph.D.

Rights and permissions

Reprints and permissions

Copyright information

© 1987 Springer Japan

About this chapter

Cite this chapter

Kew, M.C. (1987). Clinical Manifestations and Paraneoplastic Syndromes of Hepatocellular Carcinoma. In: Okuda, K., Ishak, K.G. (eds) Neoplasms of the Liver. Springer, Tokyo. https://doi.org/10.1007/978-4-431-68349-0_15

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-68349-0_15

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-68351-3

  • Online ISBN: 978-4-431-68349-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation