Clinicopathological review of hepatocellular carcinoma in black Africans

Abstract

Hepatocellular carcinoma occurs commonly in the Black population of sub-Saharan Africa. The tumour runs a particularly fulminant course and is a major cause of deaths from cancer in the sub-continent. In most Black African patients, hepatocellular
carcinoma presents clinically with typical symptoms and physical findings. However, in a significant number of the patients the tumour presents in a variety of unusual ways, some of which are the result of complications of the tumour, such as biliary obstruction as a result of invasion of the biliary tree, a Budd Chiari- like presentation with growth of the tumour into the hepatic veins, inferior vena caval obstruction resulting from growth of the tumour into the inferior vena cava, or acute
haemoperitoneum secondary to tumour rupture. Others are the result of paraneoplastic manifestations of the tumour, such as hypoglycaemia, polycythaemia, or hypercalcaemia.