Signs and Symptoms

Hepatocellular carcinoma (HCC) is often diagnosed after the tumor manifests clinical signs and symptoms. Early diagnosis is usually performed thanks to HCC screening programs for patients affected by liver cirrhosis or chronic viral hepatopathies using ultrasound and serum alfa-fetoprotien. In most HCC cases, clinical signs and symptoms of this tumor may occur several months after development, when therapy can not be curative, given the advanced tumor stage and underlying liver disease, which preclude curative options, such as ablation, resection, or liver transplantation. Clinical features of HCC are often similar to those caused by the underlying hepatic disease. It is very hard for physicians to distinguish signs and symptoms of HCC in contests characterized by an advanced liver disease. Advanced liver cancer can be responsible for accelerated liver functions deterioration caused by the intrahepatic tumor growth. In this chapter, we review the clinical signs and symptoms induced by advanced carcinoma. We also discuss particular clinical scenarios caused by metastases and paraneoplastic syndromes, sometimes described case reports in literature.