Hepatocellular Carcinoma

HEPATOCELLULAR CARCINOMA Name: Course: Date: Case Study A 55-year old male patient, married with three children, has had the history of Hepatitis C that is now chronic, and in the recent past that same progressed into cirrhosis. In the 1960s the patient used intravenous drugs and late in the year 1975, he had several transfusion due to trauma, and this increased the risk factor of the hepatitis C (Clinical Key 2013). Due to bleeding of esophageal varices in the year 2001, the condition complicated cirrhosis, however this was later brought under control using the endoscopic banding that proved effective. Two months after the treatment, the patient developed the hepatic encephalopathy and ascites. Early March in 2001, a Computed Tomography Scan (CT), was carried out on the patient, to establish the severity of the condition. The CT scan showed the patient had a mass lesion on his liver in segment 7, within the dimensions of 7×7.4×6.8 in centimetres. After a period of one month, another CT scan was undertaken on the patient, from which it was established that the mass lesion had developed further to 11.5×12.3×10.5cm. The patient’s serum alpha-fetoprotein (AFP) was also established to have risen above 17,000ng/mL. In May of 2001, the patient was put under Chemoembolization using adriamycin, mitomycin as well as carboplatinum. By late September the same year, the CT scans indicated that the diameter of the mass has significantly reduced by 3 cm within segment 7. The AFP values too had reduced considerably compared to previous readings. In December of the same year, the patient underwent orthotopic transplant of the liver and the explants indicated that the cirrhosis was advanced and that there was hepatocellular carcinoma which was residual according to the histological evidence. Further Chemoembolization was administered on the patient, and after the second surgery, there were no residual hepatocellular carcinoma with regard to the histological evidence. Three months after the second liver transplant, chemotherapy was dropped, and the patient was put under 7 mg b.i.d. tacrolimus as well as 16mg q.d of medol, which followed after the patient has several counts of acute rejections. Although the patient was initially feeling fine, he was started on insulin after developing diabetes (Axelrod 2012). When his liver was examined again, there was evidence of grade 3 chronic hepatitis C and some mild signs of rejection. Three months later the patient was diagnosed with recurrent Hepatocellular carcinoma after a liver biopsy, and was now experiencing diarrhoea and was icteric. In the month that followed the patient deteriorated fast and finally succumbed. Anatomy of the liver At the weight of around 3 pounds which translates to around 1.66 kg in humans, the liver is the second largest organ in the human body, after the human skin, which covers the entire body making it the largest organ. However, within the human body the liver is t...