Epidemiology, pathogenesis, diagnosis, surveillance, and management of hepatocellular carcinoma associated with vascular liver disease

Abstract

Vascular liver disease (VLD) presents special challenges in the diagnosis, surveillance, and treatment of hepatocellular carcinoma (HCC). HCC arising in the setting of vascular liver disease is often thought to be due to elevated hepatic arterial blood flow, rather than progressive fibrosis from chronic inflammation as with other chronic liver conditions such as viral hepatitis, autoimmune, and metabolic liver diseases. Vascular alteration inherent in VLD often impedes HCC non‐invasive diagnosis and loco‐regional treatment that depend on vascular properties found in typical liver environment. Benign and pre‐malignant liver nodules such as focal nodular hyperplasia and hepatocellular adenoma are also more common in certain VLDs, further adding to surveillance and diagnostic challenges. In this synopsis, we aimed to review available literature on the epidemiology, surveillance, diagnosis, and management of HCC in patients with VLD and specifically Budd–Chiari syndrome, congenital porto‐systemic shunts, Fontan‐associated liver disease, hereditary hemorrhagic telangiectasia.

Hepatosplenic Schistosomiasis-Associated Chronic Portal Vein Thrombosis: Risk Factor for Hepatocellular Carcinoma

“…Thus, depending on the case, other methods should be employed to investigate those lesions, such as the use of hepatospeci c contrasts, or even complementation with histopathological examination [27]. In our study, HCC cases had typical image characteristics, and in two patients HCC presented portal vein tumoral thrombosis.…”

Hepatosplenic Schistosomiasis-Associated Chronic Portal Vein Thrombosis: Risk Factor for Hepatocellular Carcinoma?

“…The association between HSS and HCC has not been clearly established 7 , 25 , 26 , 27 . Schistosomiasis could be associated with carcinogenesis due to different mechanisms such as chronic inflammation, affecting the production of proteins and modulation of enzymatic activities and gene expression 23 .…”

“…In addition to PVT, schistosomiasis itself seems to be associated with hepatic carcinogenic potential 1 , 23 , 25 , 28 . Both experimental and clinical studies in the last 40 years sought to demonstrate a direct association between schistosomiasis and primary liver cancer 12 .…”

Exosomal lncRNA HMMR‐AS1 mediates macrophage polarization through miR‐147a/ARID3A axis under hypoxia and affects the progression of hepatocellular carcinoma

“…At present, the 5‐year recurrence rate of HCC after radical resection is 61.5%, while the recurrence rate of large HCC exceeds 80%. Even small HCC has a 5‐year recurrence rate of 43.5% 4 . In short, the high recurrence rate after HCC surgery or interventional therapy seriously affects the survival and prognosis of patients.…”

“…Even small HCC has a 5-year recurrence rate of 43.5%. 4 In short, the high recurrence rate after HCC surgery or interventional therapy seriously affects the survival and prognosis of patients. Therefore, in view of the limitations of existing treatment decisions on the clinical prognosis of patients with HCC, it is extremely urgent to understand the mechanism of the occurrence and development of HCC, and to seek biological targets with early diagnosis, clinical treatment, and prognostic value.…”