Hepatocellular Carcinoma in Cirrhosis

HCC is the most common primary malignant liver tumor and the 5th most common malignancy worldwide. HCC is three times more common in men than in women and has a multifactorial etiology. Chronic liver inflammation and necrosis promote hepatocarcinogenesis in the context of hepatitis B and C infections, iron overload, aflatoxin exposure, and fatty liver disease. The vast majority of cases of hepatocellular carcinoma in the United States develop in the setting of cirrhosis, usually macronodular type. About 3% of patients with cirrhosis develop hepatocellular carcinoma annually. The involvement is usually more diffuse (as seen here) than the tumors occurring in non-cirrhotic livers.