Presentation and Evaluation of Hepatobiliary Malignancy

Hepatobiliary tumors comprise a heterogeneous group of malignancies including hepatocellular carcinoma (HCC), gall bladder carcinoma, and cholangiocarcinoma. These tumors are associated with bad prognosis. Other rare cancers of this group include pediatric hepatoblastoma, epithelioid hemangioendothelioma, and angiosarcoma. The clinical presentation of HCC can range from no symptoms to symptoms of chronic liver damage and liver cirrhosis. USG is the first imaging tool used for evaluation of HCC. This chapter will explain in brief the presentation, evaluation, and staging of HCC. Cholangiocarcinomas (CCA) are the biliary tract malignancies that originate from the epithelial lining. ~90% of cholangiocarcinomas are adenocarcinomas. Early-stage patients are often asymptomatic. Intrahepatic cholangiocarcinoma usually presents late and with nonspecific symptoms like weight loss, fever, anorexia, malaise, fullness, and abdominal pain. Gallbladder cancer can remain asymptomatic for an extended period during its early stages. Even when symptoms do manifest, they are nonspecific like dyspepsia or indigestion leading to patients presenting late when the disease advances. This chapter will describe in brief the presentation, evaluation, and staging of hepato-biliary tumors.